AURORA, Colo. (KDVR) — If Walmart charged you a facility fee for merely walking through the doors, you might start shopping at Target, or vice versa.
When Michael Kark took his 5-year son to see a psychologist to treat his son’s food allergies, he had no idea simply walking into the doctor’s building would cost him 25 times more than the actual medical visit.
“We got a $20 bill for the doctor and then a couple of weeks later we got a second bill for $503,” Kark said.
The Problem Solvers reviewed Kark’s bill, which confirmed he was charged a $20 co-pay for the doctor visit, but then Children’s Hospital Colorado charged his insurance $793 for a facilities fee.
Kark’s insurance company, United Healthcare, stated its contract only allows the hospital to charge $531, of which United Healthcare paid $28 — leaving Michael Kark to pay $503.13 for a facilities fee.
“Why this was being charged on a behavioral health visit? There were no vital signs, there were no titanium screws, there was no surgery. This was literally just a lamp and a couch,” Kark said.
So a 45-minute appointment on a sofa and a $503 charge to keep the lights on? “They have a beautiful new building, they say,” Kark said.
Who regulates ‘facilities fees’ in Colorado?
The doctor’s office is located in a building next door to Children’s Hospital Colorado, and Children’s Hospital owns the building.
Consumer advocates tell the Problem Solvers that as more hospitals buy up doctor practices, patients can expect to see facility fees added on to what’s traditionally just been a routine doctor’s visit.
“It’s really concerning because it feels very much like a surprise bill,” sad Adam Fox, the deputy director at the Colorado Consumer Health Initiative.
“I think we have felt that facilities fees are taken advantage for ER and in-patient hospital services, and now that they are being used in this way, [for out-patient services], this is pretty nefarious,” Fox said.
Children’s Hospital Colorado declined an on-camera interview but in an email stated:
Physicians who provide services at our hospital system bill their professional fees, and Children’s Colorado separately bills our fee for the use of our facility. Our fees cover the costs of running a comprehensive children’s hospital system that specializes in pediatric care in a conducive environment that is best for all children across the communities we serve. The facility fee includes items such as the equipment and supplies that are used to treat a patient, nursing, clinical and administrative support staff, technology and the facility itself. Our charge structures and billing processes must follow state and federal regulatory requirements, and they are thoroughly evaluated at least annually.”Children’s Hospital Colorado
It should be noted that when Children’s Hospital Colorado stated its billing processes are “thoroughly evaluated,” it is Children’s Hospital that is evaluating itself. The Problem Solvers reached out to the Colorado Division of Insurance and the Colorado Department of Public Health and Environment, and both agencies confirmed they do not regulate facility fees — let alone cap them in any meaningful way.
“There’s not really any recourse for consumers because there are no regulations or parameters around facility fees whatsoever in the state,” Fox said.
“It does seem like an insane amount to walk through the door, in addition to that we were supposed to take our son to see this person once a week, and so we haven’t continued with the services because it’s so egregious,” Kark said.
Surprise fee stops dad from treating his son
The Centennial father said it might be a good business model for Children’s Hospital Colorado, but it’s a bad medical model since it means his son won’t be coming back for weekly therapy sessions.
“Not having anybody tell you that you’re about to get whacked for a $500 fee feels like it’s not coming from a genuine place,” Kark said.
After FOX31 reached out to Children’s Hospital Colorado, Kark received a phone call from a hospital executive and was told the hospital might be willing to cut his bill by 35%, which would mean he would still have to pay more than $300 for the facility fee.
If you’ve received a facility fee on your medical bill that you felt was egregious, email the Problem Solvers at firstname.lastname@example.org and let us know about it with the subject headline “Facility Fees.”