Yes I had to pay a significant hospital fee just to see a specialist at Medstar Georgetown (10 minute office visit). I tried to refute but unsuccessful. The doctor was excellent so I put up with it for a few years because I only saw him once or twice a year then I left Medstar when he retired.

Medstar Georgetown is a nightmare to deal with administratively

It seems like the two options are changing doctors or changing insurance. Neither is easy-- for the insurance, you'd need to wait til open enrollment and then have the change start Jan 1.

I assume you have asked the provider whether there is an alternate office? (Several of my doctors have two different offices that they go to on different days of the week.)

This is common and most insurance plans cover the facility fee (for a reduced negotiated rate). We also had BCBS federal and I have a child with complex medical needs and we also had a large facility fee for every single appointment at Children’s that was not covered. It was a significant amount of money until we hit our max out of pocket for the year.

OP, can you change plans during open enrollment? We had a job change and have not had a plan that didn’t cover it since.

Anonymous wrote:You need to push back with the insurance. I had something similar in that I was diagnosed with gestational diabetes when I was pregnant. Had to meet with a dietitian and get set up with a glucose monitor. Easy, right? Not really. The office of the dietitian was located inside Holy Cross Hospital. My insurance company—BC/BS- kept charging me for unauthorized hospital visits. If the dietitian had been working across the street, there would have been no issue. It was a nightmare because the charges all came to light as I was giving birth. I eventually got it covered and worked out.

NP
How do you dispute this kind of thing with your insurance if they say, well you saw the doctor who works in that facility, which means you used the facility that costs $350?

You need to push back with the insurance. I had something similar in that I was diagnosed with gestational diabetes when I was pregnant. Had to meet with a dietitian and get set up with a glucose monitor. Easy, right? Not really. The office of the dietitian was located inside Holy Cross Hospital. My insurance company—BC/BS- kept charging me for unauthorized hospital visits. If the dietitian had been working across the street, there would have been no issue. It was a nightmare because the charges all came to light as I was giving birth. I eventually got it covered and worked out.

I've seen several different specialists at the University of Maryland, with Fepblue Basic. All covered normally.

Is this a new fee since the pandemic?

Anonymous wrote:Ridiculous. Vote early, vote often! is all I can say.

Or perhaps see if Dr will meet you at a Starbucks and accept a personal check.

Vote for what? Are you advocating voter fraud? No one wants to be a doctor anymore because getting paid $7 for 10 minutes can’t keep you in business.

We had this issue. We are in DC and have non-Fed Carefirst. My child had therapy at Children's National and and the insurance co charged us a $50 facility fee for every (weekly!) visit plus the co-pay for the therapy visit. We were also seeing a number of doctors there and so often had two visits a week! We ended up seeing a different non-hospital therapist where we had to pay out of pocket, but had a better rapport with our child and we figured we would rather pay the $100 straight to them plus not have to deal with parking at Childrens. I know it's not always an option though. We also, when we have to see other doctors at Children's usually opt to see them in the Fairfax office b/c, yes, we would rather drive to Merrifield than the main hospital campus that is 10 mins from our house!!!! Anyway, the facility fee issue was with the insurance co, not the hospital.

Anonymous wrote:

Anonymous wrote:Find someone in network with your insurance. That’s what everyone has to do.

I wish it was that easy. The doctor is in network with our plan. It’s because their office is on the hospital campus that we are charged this special “facilityfee”

What does the Dr's office say? That's pretty outrageous.

And push back with your insurance - if the doctor is in-network then there should not be an extra fee for you to access care

Are you a MD resident? I'd be writing my state reps, my Congressperson, and my Senators.

Then shine light on it - NPR has a series that highlights outrageous medical bills:

https://www.npr.org/series/651784144/bill-of-the-month

It is truly amazing that we as a people allow this ridiculous gouging.

I dealt with this a few years ago with United - it was so dumb. My OB’s office was on a hospital campus and they tried to charge these “hospital based facility fees”. It was a normal doctor’s office that just happened to be in a medical building attached to the hospital. I got my company’s HR involved and they did manage to sort it out for me.

Anonymous wrote:

Anonymous wrote:Find someone in network with your insurance. That’s what everyone has to do.

I wish it was that easy. The doctor is in network with our plan. It’s because their office is on the hospital campus that we are charged this special “facilityfee”

So the hospital is out of network?

Ridiculous. Vote early, vote often! is all I can say.

Or perhaps see if Dr will meet you at a Starbucks and accept a personal check.

Anonymous wrote:Find someone in network with your insurance. That’s what everyone has to do.

I wish it was that easy. The doctor is in network with our plan. It’s because their office is on the hospital campus that we are charged this special “facilityfee”

Find someone in network with your insurance. That’s what everyone has to do.

We see a specialist at the University of Maryland who doesn’t have a private practice. We were just informed there will be a $350 facility fee for each office appointment. We have BCBS Federal and they will only pay $7.00. So outrageous and now we have to find a new specialist.
Ugh. Anyone else dealing with this?