Beware Palm Drive Hospital and Medical Centers
I want to alert everyone to a practice that Palm Drive Hospital has decided to implement that could affect you financially without your knowledge. As of 1/1/2011, office visits to PPO doctors at Palm Drive Medical Centers will be billed with the hospital's tax id# which means your visits will be subject to your deductible (instead of being charged your office visit co-pay) and they will tack on an additional $120 "facility fee" for you to walk in the door of the doctor's office. I have written a letter to Palm Drive and they are doing nothing to remedy this preposterous situation. I have changed doctors and will have nothing to do with Palm Drive Hospital or Medical Centers any more. People are going to be leaving these doctors' practices in droves. Who will pay these extra fees knowingly?? If anyone has any advice on this, I would be grateful.
Re: Beware Palm Drive Hospital and Medical Centers
Quote:
Posted in reply to the post by Leelash:
I want to alert everyone to a practice that Palm Drive Hospital has decided to implement that could affect you financially without your knowledge. ...
Thanks for posting this Leelash! I'm going to see if I can get Palm Drive to respond.
Re: Beware Palm Drive Hospital and Medical Centers
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Posted in reply to the post by Barry:
Thanks for posting this Leelash! I'm going to see if I can get Palm Drive to respond.
Hi Barry, Here is the response you asked for from Palm Drive Hospital. It's from the CEO, Rich Polheber. Thanks! Carol
April 16, 2011
There has been a lot of confusion about some of the fees being charged at the Palm Drive Medical Center, and I wanted to explain what’s happening and answer some of the questions Leelash raised.
It will take a minute to explain it, so please bear with me.
The first thing to know is that Palm Drive Medical Center operates under state and federal regulations that classify it as a department of the hospital. So the way it does its billing is the way a hospital does its billing.
If you go to a physician in private practice at his or her office, you (or your insurance company) get one bill. That bill includes the physician’s professional fee for service plus a certain amount to cover the overhead – supplies, office rent, staff salaries and things like that.
But when you go to a hospital or a hospital-based medical center like Palm Drive, the law requires your bill to be separated into two bills -- one for the physician’s professional fee and a separate one for the overhead. The bill for overhead is called a “facility fee.”
If you were to add up the two Palm Drive bills – the physician’s fee and the facility fee – you would find the total charge was very competitive with the total charge on the one bill you get from a physician in private practice.
But there’s still a problem, and Leelash put his finger on it.
Insurance companies treat the two-bill combo differently than they do the one bill from a private physician (I don’t know why). Depending on how the insurance company figures it, your out-of-pocket costs can be higher than at a private physician’s office, even though the total bill could be the same. This is especially true if you have a policy with a deductible.
Nobody wants to pay more money in these economic times, but Palm Drive doesn’t have any control over the insurance companies. We are looking around to see if there is something we can do to make this easier on people.
Meantime, we want you to know that we are very proud of our excellent physicians and the high quality medical care they provide. We have a 70-year history of providing the best care possible, close to home, and we’re committed to continuing to do that for the next 70.
Richard Polheber, CEO Palm Drive Hospital
Re: Beware Palm Drive Hospital and Medical Centers
With all due respect to Mr. Polheber, what he and the rest of the folks at Palm Drive continue to ignore is that this was a CHANGE in policy which I was not alerted to before going to the same doctor I have been going to at the same medical center for the past 3 years. If I had known of this CHANGE in their policy (to bill for a facility fee), I would not have gone to that doctor on that day. If this is the "law" as Mr. Polheber states, then why didn't they bill in this way all the other times I went to Palm Drive Medical Center in the past? He states the "the charge is very competitive." They charged me $120 for a facility fee PLUS $95 for the office visit. How is that competitive with my $30 co-pay? **Could somebody please try to make this point to Mr. Polheber for me. I am not objecting to the fee, per se, I am objecting to not being informed of this change so I could decide whether I wanted to continue to see this doctor with these additional charges. I am frustrated that my issue is not being heard.
Re: Beware Palm Drive Hospital and Medical Centers
Quote:
Posted in reply to the post by Leelash:
... I am not objecting to the fee, per se, I am objecting to not being informed of this change so I could decide whether I wanted to continue to see this doctor with these additional charges. ...
I think this is a very valid point, and is indicative of the larger problem, which is that fees for medical services, at most all medical providers, are rarely disclosed in advance.
Re: Beware Palm Drive Hospital and Medical Centers
Quote:
Posted in reply to the post by carolb:
Hi Barry, Here is the response you asked for from Palm Drive Hospital. It's from the CEO, Rich Polheber. Thanks! Carol
April 16, 2011
There has been a lot of confusion about some of the fees being charged at the Palm Drive Medical Center, and I wanted to explain what’s happening and answer some of the questions Leelash raised.....
Richard Polheber, CEO Palm Drive Hospital
No one could be more dissatisfied with our nation's health care system than I am at this point. Yet i do understand that, when you have both government and big insurance involved in something to the extent it is in healthcare, you can bet things are going to be both confusing and screwed up.
I am a Kaiser member, and I can tell you it's no better working through their system. In fact, I'd like to acknowledge Palm Drive for the excellent quality of care that my partner received there a couple weeks ago when she had her hip replaced. The Kaiser machine is often impersonal, and my annual "physical" with my general practitioner is now down to about 6 minutes in length--about enough time to make sure I'm still breathing, and that's about it.
Palm Drive staff were delightful and attentive to my partner, and the quality of care was superb, from the doctor (Bollinger) all the way to the nurses and CNAs. We're grateful that we have a small, personal and local place she could get treated.
Billing issues aside (and not to negate LeeLash's experience), we have to keep the entire system in mind when criticizing anyone or an institution trying to provide care these days. We could do far, far worse than Palm Drive. Just join Kaiser if you don't believe me.
Re: Beware Palm Drive Hospital and Medical Centers
Palm Drive Follow Up:
I filed a complaint with the Better Business Bureau and Mr. Polheber agreed to reimburse me for the "facility fee". I am happy with this result and I only wish I didn't have to take it that far to get the result which I feel I deserved.
I also wanted to make it clear to "iaim2xl" that I was not complaining or commenting on the quality of the services I have received at Palm Drive. I was just commenting on what I see as an unfair practice not to notify me of a substantial change in their billing policy so I could make a choice about whether to go there or not.
Re: Beware Palm Drive Hospital and Medical Centers
I haven't been to the Medical Center, but have been using Palm Drive as my hospital for 30 years, and have no complaints at all.
Ten days ago, I had a total hip replacement (Dr. Bragonier) and I'm already walking without even a cane. I found out after the fact how fortunate I was that this was my hospital and Dr, Bragonier my surgeon.
In Sonoma County, ONLY Palm Drive Hospaital and ONLY Drs. Bragonier and Bollinger perform this hip replacement surgery using the anterior approach (as opposed to the posterior). This anterior incision is way less restrictive after the surgery and, I understand, has a faster and less painful recovery time.
Dr. Bragonier did knee replacement and shoulder surgery for me in the last few years, and I sure wouldn't go anywhere else.
Quote:
Posted in reply to the post by iaim2xl:
No one could be more dissatisfied with our nation's health care system than I am at this point. Yet i do understand that, when you have both government and big insurance involved in something to the extent it is in healthcare, you can bet things are going to be both confusing and screwed up.
I am a Kaiser member, and I can tell you it's no better working through their system. In fact, I'd like to acknowledge Palm Drive for the excellent quality of care that my partner received there a couple weeks ago when she had her hip replaced. The Kaiser machine is often impersonal, and my annual "physical" with my general practitioner is now down to about 6 minutes in length--about enough time to make sure I'm still breathing, and that's about it.
Palm Drive staff were delightful and attentive to my partner, and the quality of care was superb, from the doctor (Bollinger) all the way to the nurses and CNAs. We're grateful that we have a small, personal and local place she could get treated.
Billing issues aside (and not to negate LeeLash's experience), we have to keep the entire system in mind when criticizing anyone or an institution trying to provide care these days. We could do far, far worse than Palm Drive. Just join Kaiser if you don't believe me.
Re: Beware Palm Drive Hospital and Medical Centers
SO glad you are recovering happily Sara! We need you healthy around here.
kathy
Quote:
Posted in reply to the post by Sara S:
I haven't been to the Medical Center, but have been using Palm Drive as my hospital for 30 years, and have no complaints at all.
Ten days ago, I had a total hip replacement (Dr. Bragonier) and I'm already walking without even a cane. I found out after the fact how fortunate I was that this was my hospital and Dr, Bragonier my surgeon.
In Sonoma County, ONLY Palm Drive Hospaital and ONLY Drs. Bragonier and Bollinger perform this hip replacement surgery using the anterior approach (as opposed to the posterior). This anterior incision is way less restrictive after the surgery and, I understand, has a faster and less painful recovery time.
Dr. Bragonier did knee replacement and shoulder surgery for me in the last few years, and I sure wouldn't go anywhere else.
