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HOSPITAL: Facility fees explained

| June 23, 2010 10:00 PM

Recently, the Kootenai Cancer Center billing department received a question regarding facility fees. It is important to note that clinics such as the Cancer Center are hospital-based outpatient clinics. They provide many more services and more advanced equipment than most doctors’ offices and are more highly regulated than physicians’ offices. They also use a billing model that is structured more like a visit to the hospital than a visit to a doctor’s office. 

Patients at the Cancer Centers receive two separate bills, one to cover the physician’s time and another for the facility. Just as the name suggests, facility fees help cover expenses such as staffing, equipment, utilities and so on. The charge is covered by most insurance providers. However, it is often applied to the patient’s deductible, meaning the patient is responsible for paying this fee until his or her deductible has been met. 

Physicians who do not practice in a hospital-based clinic typically just roll facility fees and their time into a single bill for your office visit.

Understanding your medical bills and insurance coverage is important. Any time you have questions about a medical charge, take a few minutes to call your provider’s billing office and your insurance carrier. They can explain the charge and may be able to suggest payment options that suit your needs.

BROCK MERRILL

Business Services Director

Kootenai Health 

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