As a physician of over 40 years and a patient advocate who has spent many years working with the legislature to improve patient safety and fairness in insurance reimbursement, I am disgusted by a recent trend in health care billing that I believe the citizens and legislators of Connecticut should be made aware of.
Very recently my wife had a follow up doctor’s appointment for a fortunately minor medical problem. She saw the doctor, discussed alternatives, and left. After the appointment we received a letter from Yale New Haven Health that her physician appointment was located in one of their “Hospital Outpatient Departments” and therefore we could receive a second bill for out-of-pocket expenses for a “separate hospital facility fee.” This would be in addition to the physician’s fee which is covered by insurance.
This is nothing more than a way for Yale New Haven, and other hospital systems that utilize this unethical billing, to suck every last penny out of their patients. Most of us as patients sign up for health insurance either individually or through work, which offers to cover doctor visits, emergency care, laboratory services, outpatient surgery and hospitalizations. This new “hospital facility fee” for providing services which doctors have provided at no extra charge to patients for years is nothing more than a loophole in insurance coverage that Yale is taking advantage of.
As a physician in private practice for all of my ancillary office expenses, including highly trained technical and nursing staff, significantly expensive high technology imaging and diagnostic equipment which frequently needed updating, I was never allowed to charge an extra technical fee that was not covered by insurance. If these large hospital corporations want to charge a fee for actual services utilized it should be part of a negotiated fee schedule with the insurance companies and not be tacked on as an “facility fee due to the need for nursing, medical assistants, special medical equipment, and other regulatory requirements” (quote taken directly for the letter sent by Yale) which all physicians in private practice need and utilize in their offices at NO EXTRA out of pocket expense to their patients.
This practice of large hospital corporations of billing patients out-of-pocket (anywhere from $25-$500 — again as quoted from the Yale letter) for what all physicians have always negotiated as part of their cost of providing excellent medical care is patently unfair and should be declared immoral and illegal and stopped immediately.
Elwin G. Schwartz M.D. lives in New London.