ALBUQUERQUE, N.M. (KRQE) – When it comes to openness and transparency in medicine, our health care system has utterly failed. Exhibit Number One? Cryptic medical bills are indecipherable. “This is another form of craziness in American health care,” says former New York Times Reporter Elisabeth Rosenthal. She is the author of a best-selling book on health care.
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“I have never seen anything like this. I was totally taken aback when I received this bill out of the blue,” says East Mountain resident Abi Ritz. Abi had an appointment with her Lovelace Medical Service doctor to discuss a change in medication. “It was scheduled as a Zoom call, 10 a.m. on December 10th,” Ms. Ritz said. But when the doctor failed to call at the appointed time, Abi had to leave her house for a meeting. “I’m driving down I-40. Here’s my phone (ringing), there’s the doctor. I’m like, Hello?”
It was a 2-minute phone call. Later, the bill arrived. On top of a $25 co-pay, Lovelace added an extra charge, $300 for something they call a facility fee. “They said this is our new billing system. ‘We charge a facility fee for the facility because the physician has to be in their office in order to have this phone call. We have to pay for that office.’ That’s what they told me. I felt like it was unethical for them to charge a facility fee when I didn’t enter the facility,” Abi Ritz tells KRQE News 13.
“The Lovelace Medical Group started imposing facility fees last year on all Telehealth and in-person doctor visits. They say the fees are charged to cover the costs of maintaining the building.
Ron Liss, President of the American Patient Right’s Association, says a $300 facility fee for a five-minute phone call is “Not at all” reasonable. “If the patient is being charged for a telemedicine visit, we don’t believe that that’s fair because the patient is not using the facilities for treatment or receiving medical advice. So we don’t agree that that should be charged,” Ron Liss said.
“I think it’s wrong,” says Albuquerque’s Michael Marchi. After Marchi’s wife got a check-up at her Lovelace doctor’s office, she noticed a $350 extra charge. The Marchi’s thought it was a mistake. “Their answer was, well, that’s called a facility charge and that’s the way it is,” Michael Marchi says.”
Lovelace explained its facility fee pays for office overhead like utilities, supplies, and salaries. In a statement, Lovelace says facility fees are explained to patients at scheduling and check-in. Michael Marchi says his wife was not aware of a facility fee prior to the invoice being sent. Lovelace declined an interview.
Lovelace Medical Group email explanation to patient regarding “Facility Fee”:
“On Oct. 1st, our clinic was changed to a hospital outpatient department, meaning we are now a division of the hospital. The charges that you have seen are a result of that change. A facility fee is charged at a clinic owned by the hospital to cover the costs of maintaining the facility (staff, building, utilities, etc.)
In addition to the facility fee, there is a charge by the doctor, who is not employed by the hospital, for his/her services.
You also questioned the charge for a telemedicine appointment. Telemedicine appointments do also have a facility fee charge as the same type of expenses are incured by the hospital.
I realize that the changes to these fees has been significant and we do not want patients to be surprised by their charges. I apologiz for the lack of communication. We are working hard to communicate prior to the appointment what the charges will be, so you the patient can make and informed decision.”Chris Lardner, Practice Director at NMHI
Is a ‘facility fee’ related to medicine or medical care? “No, of course not, it’s a business construct, not a medical construct,” says Elisabeth Rosenthal who has worked as a practicing physician and is currently Editor-in-Chief for Kaiser Health News.
“Facility fees are to compensate a hospital for all the costs of running a big health care place that aren’t really covered by what happens between you and your physician in an exam room. In US medicine, we’ve accepted the notion that facility fees are legitimate. They’re sort of like when you went into Wal-Mart, there was an admission charge. That’s what a facility fee is,” Elisabeth Rosenthal said.
And then, just when you think you’ve seen it all, along comes Albuquerque businesswoman Mary Maxwell. “Oh, I should have never done it,” Mary Maxwell says.
And Tim Saylors. “I was flabbergasted,” Tim Saylors said.
Tim Saylors and his wife were visiting Albuquerque and needed a COVID-19 and a TB test. Mary Maxwell, who owns a mobile testing business called Mobile Exams by AtoZ Phlebotomy, came to the Saylors’ hotel, administered the tests, and sent them a bill for $189.55.
Now the Saylors are not what you would call ‘prompt bill payers.’ Over the next month, Maxwell made numerous unsuccessful attempts to collect the debt. And then, she crossed the line. Maxwell sent Saylors an email. In writing, she threatened to falsify the test results reporting them as positive if payment was not received.
“This is wrong, wrong, wrong,” Tim Saylors says. “If you have a delinquent bill you send it to a collection agency you don’t threaten to falsify medical records,” Saylors said.
“In hindsight, I just I wish I wouldn’t have done it,” Mary Maxwell tells KRQE News 13. “I had an absence of judgment. I’ve never had someone not pay for a service in 15 years. I should have just turned them over to a collection agency instead of sending that email,” Maxwell says.
To date, the $189 bill remains unpaid.