We the Patients

Amy Zarin facility fees

Even health literacy consultants are surprised by facility fees — Amy Zarin, Manhattan, NY

Healthcare plans can mystify anyone, but even health literacy consultant, Amy Zarin, was shocked by the unexplained bills she received after her daughter was treated at NYU Langone. After her teenage daughter was injured while dancing, Amy took her to NYU Langone’s Orthopedic I-Care. About a week later, she received an inexplicably high bill featuring a “service charge” totaling $119.03 and a “facility charge” totaling $1,236.

These charges were new for NYU Langone. When her daughter fractured her finger four years prior, Amy took her to the same facility. She had no problem getting her daughter an X-ray, a splint, and a referral for a follow-up, all without a facility fee or a service charge. This time, however, Langone had a very different procedure. After having Amy sign several waivers on an iPad, a physician attended to her daughter. He quickly confirmed that she hadn’t broken any of the bones in her foot. The visit ended with a referral to a doctor at the Harkness Dance Clinic and several rounds of physical therapy. Amy was relieved that her daughter’s injury wasn’t too serious and that she had stayed in-network for care.

To Amy’s surprise, however, the bill she received included both a “service charge” and a “facility charge” costing more than $1,300, a serious financial burden given her $5,000 annual deductible. This came in addition to the physician’s bill of $156, a discounted rate for Cigna members.

To make matters worse, when she called NYU Langone to find out if other health services would incur similar charges, Langone refused to answer her. She had to rely on her health insurance’s itemized explanation of benefits to find out the actual costs she would be held responsible for. During her investigation she discovered that the physical therapy she had agreed to cost 10% more than both NYU Langone and Cigna had told her. This surcharge was due to an undisclosed “service charge” she was told was a “state tax.”

Amy reached out to NYU Langone by phone and in a letter to its CEO, in addition to filing an appeal with Cigna. Both the hospital and Cigna responded with terse rejections. After months of frustrating back-and-forth, she has now filed a complaint with New York State’s Department of Financial Services. According to her own research, the facility and service charge NYU Langone I-Care tacked onto her bill was at least $1,000 above the average charge for other hospitals in New York City. Unfortunately, without a way to accurately compare healthcare prices, Amy—like other healthcare consumers in New York—has been left in the dark about the benefits her own plan offers and the costs she can expect for her and her family’s care.