Outpatient Clinic Visit Hospital Fees


(Sarah) #1

Hi - I’m a 35 year old T1D living in MA insured by BCBS MA. I’ve been seeing an endocrinologist affiliated with Brigham and Women’s hospital for 8 eight years (different docs at different sites, but same organization nonetheless). Of the billing statements for the last three visits to my current endo, the two most recent ones (for July and December) included a charge called “outpatient clinic visit - hospital,” in addition to the co-pay I am responsible for as part of the “professional services” fee. After researching this for hours, it appears that most endos in the area work in some kind of “outpatient” or “center for specialty care” setting of a hospital, which means there’s little chance of my finding an endo who I can visit without having to pay an additional “hospital fee” (which right now is close to $175… and at visits every three months, that adds up. My deductible is $1,000). Anyone here from MA or Nashua, NH area who has found an endo with a private practice where you don’t have to pay that extra “outpatient clinic hospital visit” fee?

ALSO - WHY IS HEALTHCARE THIS COMPLICATED?!?!?!!!


(joe) #2

@shathaway811 hi Sarah, I can’t help directly, so sorry for that, but my Endo in Jersey has a private practice and doesn’t cause an outpatient hit in my insurance.

Patient care is a business. You are a repeat customer with insurance. Maybe you find an Endo and lay down the law. You can strike a deal for no outpatient or maybe every other visit. Your only leverage is you will be back. Some doctors need to be fired, others will work with you. You are the pay ticket so make sure you are not afraid to go elsewhere.

I agreed to 2 visits per year at the Endo and 1 at my PCP. I split my scripts so that not 1 doctor has all the leverage. These people are not your friends, they are your vendors. So far it’s been working. Good luck.


(Dennis J. Dacey, pwD) #3

Hi Sarah @shathaway811,
I know the struggles paying for diabetes care. For really excellent care - and maybe you can negotiate costs to fit your BC/BS - I suggest that you cross the street to the world renowned Joslin Diabetes Center at One Joslin Place.