MissConstrue4d ago

Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.

So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.

I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)

So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."

And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.

Those lawyers never met me.

#medicalDebt #USHeathcare #profiteering

Show threadMissConstrue3d ago

So, I'm going to the mat on this facilities fee thing with Baylor. $300 to see a doctor and $300 to see a building is obscene.

I've been doing research, which was not at all easy, because damn, they bury this stuff.

There was a Medicare change, and medical practices can now charge facility fees if they are part of a hospital.

How it was interpreted by money men was "buy every medical practice and put them under the hospital umbrella, and poof, double billing".

So, I tracked down the billing code and was able to drill down into the APC and CMS and find out what Medicare would pay U&C. (Usual and Customary)

I have to start with the national unadjusted APC payment: $134.00, Apply locality and wage index adjustments, which have to be looked up somewhere else, and the end result of 6 hours of research and math:

$133.47 Which is still absurd, but almost a third less absurd.

Show threadM.S. Bellows, Jr.
@MissConstrue Happened to us over a decade ago: child met with a pediatric psychiatry resident at OHSU, and we were billed separately for the resident's time and the tiny room (his regular office) they talked in. Infuriating.
Mar 31 at 7:19amWeb
Show threadMissConstrue3d ago
@msbellows Yeah, they've been able to do it for a long time if the "office" was in a hospital building. But now, it can be any practice "owned" by a hospital conglomerate. The doctor I saw was not in a hospital. There are no hospital facilities in that building. There are only medical practitioners, with easy access to a nearby er. There's no surgery, no intake, no billing office, just an office building filled with medical professionals in their own practices.
Show threadGenerally Salty3d ago
@MissConstrue @msbellows Wow. Glad I did not follow up with the U of L hospital ophthalmology office after my ER visit. Went to my usual eye doc who referred me to another unaffiliated practice for laser repairs.