Elmhurst Memorial Healthcare’s new hospital campus hasn’t opened yet, but already some are asking how much it’s going to cost to use it.
“What’s up with the facility fee being charged by EMHC?” one online reader asked Elmhurst Patch. “I have heard other moms talking about [their pediatricians] dropping their affiliation with Elmhurst Hospital because of this fee. Is this true or not?”
The answer is, a facility fee is being charged, but it's nothing new.
Patients and/or their insurance carriers have always paid two types of fees for outpatient physician services. One covers professional costs for time and medical advice. The other is called a facility fee, although it covers more than just office space. It includes nursing staff, clerical support, computer systems, medical supplies and more.
A change in billing practices, however, has made the fee more visible to users, in some cases, said Sheri Scott, EMHC's executive director of marketing and public relations.
“Physicians affiliated with EMHC recently implemented a new hospital-based model of care,” Scott said. “Charges for professional services and facility fees were previously combined into one bill. Hospital-based clinics are required to bill separately for professional and facility fees. This change in billing practices for outpatient physician offices, however, is not at all associated with the new hospital.”
If a patient has insurance coverage, Scott said, these fees are subject to the terms of individual insurance policies.
“An insurance company will either process these two bills as it did when they were billed as a physician office or may process them as an outpatient hospital claim,” she said. “Actually, the one for the physician’s professional services has been reduced because of the change.”
Scott says hospital-based billing is widely used for integrated healthcare services like those at Elmhurst Memorial Healthcare. And since the change took effect in January of this year, it could have fueled speculation about a new facility fee.
“Again, this is not a new fee. It is simply a change from one bill for both professional and facility charges to two separate bills,” Scott said. “There is no fee for using the new hospital, and no providers have severed their affiliations with EMHC because of the move to a hospital-based model.”
Scott says the new hospital-based model of care offers many advantages to patients, including integrated health systems and electronic medical records (especially helpful in emergencies), consistency in delivery of care, high standards for safety and quality of care and state-of-the-art facilities.
The move to a hospital-based model of care for affiliated physician practices allows EMHC to continue to attract high quality providers and make them available to patients, Scott said.
The new facility, at 155 E. Brush Hill Road in Elmhurst, on June 19, and will be open for patient care on June 25.