Patients surprised by hospital's 'co-pay' charge

Facilities fee

Credit: WFAA

Texas Health Resources patient Jim Serur says he was surprised by a "facilities fee" charge after visiting his doctor's office. The hospital says it's no big deal, but to senior citizens like Serur, it is.



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Posted on August 12, 2013 at 10:06 PM

Updated Wednesday, Aug 14 at 12:00 PM


Jim Serur, 84, is a former economics teacher who watches his money. He knows what his health insurance covers and what it doesn't.

So when he got a mysterious bill for a "co-pay" after visiting the Senior Health Center at Presbyterian Hospital last year, he called his health insurance company to make sure he didn't owe any money.

They said he didn't, so he threw the $35 bill away.

Months later, Serur received a notice from a collection agency demanding $35. He called Presbyterian Hospital, which is run by Texas Health Resources, for clarification.

He said he was told the $35 was for a "facilities fee."

"It's a license to steal," Serur said. "It's not honest, because it's not logical. What is 'use of the facility?'"

The same thing happened to Glenna Howard, who lives at the same retirement home as Serur.

Presbyterian explains it's been charging this fee for a decade. It results from the fact that the Senior Health Center is owned by the hospital, and the fee is to compensate the hospital for items such as rent, part of nurses' salaries, band-aids and gowns.

The hospital declined to be interviewed about the subject. In an e-mail, spokesman Stephen O'Brien wrote: "One or two folks who could [talk about this subject] just don't see this as a story."

"It definitely has come up in other states," said Dr. Kevin Kavanagh, chairman of Health Watch USA. "It's a very hot issue."

Kavanagh questions whether what Serur and Howard were charged is even a "co-pay."

"I think it's more of a 'surcharge,'" he said. "It's something that is I feel used for now that it wasn't really intended for. And the amount of money involved is tremendous."

Here's how much the hospital appears to be collecting in its facilities fee at the Senior Health Center, where two salaried doctors practice.

At 15 patients a day, $35 a patient, five days a week and 50 weeks a year, the hospital could be collecting $131,250 for the rent, nurses, needles, band-aids and gowns.

News 8 has learned that private physicians in the same building pay less for rent.

There is a question of whether patients know what they're being billed for when they leave the office. Serur and Howard said they weren't informed of the fee.

The hospital says it takes great pains to brief patients about the charge. It says it posts signs of the practice in its office.

We asked the hospital to provide us with a picture of the sign, but it did not.

"When you go see your doctor, if you're not sure he's your doctor or if he is a doctor employed by another employer, where are his loyalties?" Kavanagh of asked. "All of that has to be looked at by a patient. The landscape of health care has changed, and patients really need to be educated and ask what these charges are going to be up front."

Both Jim Serur and Glenna Howard eventually got the fees removed from their bills.

This time.

Ms. Howard changed doctors.

Texas Health said it apologizes for the confusion.

News 8 asked five health care providers the following question, based on the experience of patients Jim Serur and Glenna Howard:

"If I visit a doctor on salary with you at a professional building or office owned by you, am I charged a facilities fee?"

Here are their answers:

  • Baylor Health Care System — Yes
  • Children’s Medical Center — No
  • Cook Children’s Healthcare System — No
  • Methodist Health System — No
  • Texas Health Resources — Yes