Surprise ‘Facility Fees’ Leave Patients with Unexpected Medical Bills Across the U.S.
TL/DR –
Bay Area patients are being charged a “facility fee” on top of their co-pays by John Muir Health and other medical service providers. These fees cover expenses such as nurses, technicians, environmental services, interpreters, security personnel, equipment, utilities, and maintenance, however, patients are often not made aware of them upfront. The American Hospital Association argues these fees cover the true cost of healthcare, but patients and some states are pushing back, with several states outlawing the fees or requiring disclosure.
Unexpected Medical Facility Fees Shock Bay Area Patients
Unexpected “facility fees” are giving Bay Area patients like Wendy Ko a shock. Despite never setting foot in a medical facility, many are finding themselves billed for this fee. Ko, a North Bay patient, was hit with a $125 fee following her routine check-up at a John Muir Health office, where she had initially only paid her co-pay.
John Muir Health said the fee covers expenses like staff wages, equipment, utilities, and maintenance. However, Ko stated there was no clear information about this charge, and she only learned about it after receiving the unexpected bill. Despite signing a form agreeing to pay for “hospital facility services”, she was not told the exact amount beforehand, leading her to refuse payment.
This issue is not unique to the Bay Area. Viewers across the U.S., including major cities like New York, Philadelphia, Boston, Dallas, Miami, and Chicago, have complained about similar experiences. Illinois resident Valerie Timpone had to pay a $60 facility fee for a virtual visit, despite not being informed about this cost upfront.
Congress tried to prevent such surprises with the No Surprises Act in 2022, but the law fails to cover facility fees. Some states have taken action by banning these fees or requiring clearer disclosure, but others like California have not made such moves.
Professional medical bill advocate Lisa Berry Blackstock encourages patients to ask about facility fees before attending any medical appointments to avoid surprise charges. She highlights the importance of getting an itemized bill estimate in writing, which should include any facility fees.
When we contacted United Healthcare, Ko’s health insurer, about her case, they said her in-office visit had been reprocessed and would be paid in full. They apologized for an unspecified “error”. Although Ko won’t have to pay the $125 fee, her experience underscores the need for transparency around medical costs.
John Muir Health confirmed they had sent Ko’s account to collections but have since recalled it. Ko’s credit report should be clear, as the hospital doesn’t send delinquent account information to credit bureaus in line with California regulations.
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