Even Doctors Like Me Are Falling Into This Medical Bill Trap
By Dr. Danielle Ofri, The New York Times, June 17, 2024
…
A lucrative corner of the health care market is called hospital outpatient departments, or HOPDs. [This can include outpatient clinics.] They do some of the same outpatient care — colonoscopies, X-rays, medication injections — just as doctors’ offices and clinics do. But because they are considered part of a hospital, they get to charge hospital-level prices for these outpatient procedures, even though the patients aren’t as sick as inpatients…
As of 2022, federal law protects patients from surprise bills if they are unknowingly treated by out-of-network doctors. But there is no federal protection for patients who are unknowingly treated in higher-priced hospital affiliates that look like normal doctors’ offices or urgent care clinics…
One study of pricing revealed that HOPDs charged an average of $1,383 for a colonoscopy, compared with the $625 average price at a doctor’s office or other non-HOPD settings. A knee M.R.I. averaged $900, compared with $600. Chemotherapy and other medications cost twice as much. Echocardiograms command up to three times as much. Much of these costs comes from tacked-on “facility fees,” which are rising far faster than other medical costs… [end quote]
We have already discussed facility fees on METAR. This article describes inflated prices for simple procedures in addition to the facility fees.
I’m not sure how we, as patients, can protect ourselves from inflated medical bills. Even when a situation is elective and not emergency it’s hard to get accurate billing information. And we usually select medical care based on other factors (such as the experience of the doctor) rather than the price.
I haven’t received the bill for my echocardiogram yet since it has to be processed by Medicare and my medigap insurance. I wonder if it will have a facility fee since I had it done at the local Olympic Medical Center imaging facility.
Wendy