The high cost of health care
By Debra Pressey, The News-Gazette, Champaign-Urbana, Ill. | |
McClatchy-Tribune Information Services |
Last December it was
"I asked, 'How could it be so much more expensive now?'" she recalled.
The
Under a provider-based arrangement, a physician practice is converted to an outpatient department of a hospital, and patients begin seeing two charges _ one from the doctor and one from the hospital in the form of a facility fee.
As the provider-based model has been expanded to physician office locations, the total out-of-pocket expense for a visit could be more, less or the same, depending on the patient's insurance plan, she said.
Provider-based billing has been explained to patients in letters, in information included in bills, in individual conversations with patients and on
But some patients receiving those higher bill combinations aren't happy about it.
Cochlear implants are small electronic devices that can provide a sense of sound to someone who is profoundly deaf or hard of hearing, and Hubert said his daughter, Nicole, needs to come to
For a mapping visit at
"I was scratching my head there," he said.
Hubert wound up paying about
"They stuck it to my wife's company," he said.
While he's disgruntled about the charges, Hubert doesn't have any complaints about his daughter's care over the last 15 years from Dr.
But he feels
"They have certainly downplayed the impact of this," he said.
He and his wife will be paying facility fees for their daughter twice a year, Hubert said, but children with new cochlear implants go for these services about a half-dozen times a year or more, "so you've just added
Maher said her allergy serum charge was billed as an outpatient service, something she couldn't understand.
When she called to inquire about that and the increase, she said someone at
She called her insurer, HealthLink, and told them the story, Maher said.
"I said, 'You are being taken to the cleaners.'"
His out-of-pocket expense for his visit with an advanced practice nurse was
"
What happened to Gillespie: The charges for one visit to see an orthopedic doctor at
Her insurer allowed
Of the original charges,
The service was pretty much the same one she'd received at
When she learned she'd be getting two injections at
"It's a very difficult economic environment," she said. "
Provider-based is a
Reclassifying certain areas as hospital outpatient areas can bring higher
And according to
Provider-based billing has become an increasingly common way for hospitals to operate their outpatient facilities because they can cover for extra costs, according to the
However, the doctors' organization said it doesn't support provider-based billing for care delivered in an outpatient hospital system-owned practice when the care "is not dependent on the hospital facility and its associated technologies."
Nor should provider-based billing be used by hospitals to recoup or stabilize funding, or as a means of ensuring access to care, the organization said.
The doctors' group further maintains hospitals and hospital-owned outpatient practices "should be transparent about their billing policies with patients prior to providing care, particularly if the patient and/or their health plan will be responsible for both physician service and hospital facility fees."
Hendricks encouraged patients who still have questions about provider-based billing and facility fees to call
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