GREENSBORO, N.C. - When you go to the doctor’s office and usually pay one price, Then the next trip you’re charged hundreds more for the same services. Yeah that stings. Our Call For Action team is getting more and more calls about this exact situation every day! So 2 Wants To Know investigated what’s behind the surge in prices.
“It’s just not right. And that’s why I called you guys,” said Rosalind Proctor. She paid her normal co-pays and then:
“I still owed a hundred and 152 dollars and 94 cents,” she said.
The doctor’s visits had been coded as “outpatient treatment” because the doctor’s practices, had been bought by a hospital system.
“I paid my co-pay, and I shouldn’t have to pay any more,” Proctor said.
If you haven’t dealt with this yet, you probably will soon. Nowadays one in four doctor’s offices are hospital-owned according to a study by nonprofit advocacy group by Avalere Health.
Places like a Gynecologist in Lexington who’s 25 miles away from the Wake Forest Baptist Medical Center in Winston-Salem. It’s not just Wake – Cone Health has this billing practice too. Right about now, you’re probably thinking: “thanks Obama! The affordable care act is to blame.” Nope. Cone Health says that has nothing to do with the billing. More on how they explain the charges in a minute.
But first Wake Forest Baptist declined an interview referring us to this section of their website saying:
“These clinics are called hospital-based outpatient clinics. Because they must follow stricter government rules, hospital-based outpatient clinics are more complex and more costly to operate than a private physician office.”
“Ehhh, I think that’s just an excuse,” said Wendell Portter, a former insurance insider.
Potter was the head of corporate communications for Cigna. He literally wrote the book on how healthcare workers come up with ways to charge you more called: “Deadly Spin: An Insurance Company Insider Speaks Out On How Corporate Pr is Killing Health Care And Deceiving Americans.”
“The hospitals are taking on a significantly higher fee or fee that wasn’t there before simply because they can,” he said.
Not so says Jeff Jones, Chief Financial Officer of Cone Health. He says the higher price is because it’s harder to run a hospital owned doctor’s office than a traditional practice because they have to live up to different safety standards.
“Unfortunately we don’t make more money. But yes, the billing is higher, like I said the structure was intended to acknowledge the difference,” Jones said. “Our costs are higher from a regulatory perspective and our costs are higher because we also provide coverage to those people that have no insurance.”
There is hope. Patient Advocate Sheryl Scharoun says doctors are often willing to make deals with you.
“Quite often to be honest with you. But people don’t ask,” Scharoun said. “Discuss it with the physician and let him know what you were paying prior to the takeover versus now and ask for a discount.”
Not every doctor’s office owned by a hospital is billed this way. For Cone Health it’s best to ask up front. And Wake Forest Baptist Health have these lists of which ones are and aren’t.
And you might be wondering about Novant Health. A spokesperson says Novant Health has not recently purchased physician clinics and converted them to hospital-based clinics.