John Lychak of Lower Saucon Township sought treatment for a foot issue and was charged nearly $1,000 in hospital “facility fees” for the care he thought had taken place in a doctor’s office rather than a hospital.
The debate goes to another level. Jamie McFadden of South Whitehall Township hired a lawyer who filed a proposed class-action complaint, alleging that facility fees imposed by businesses affiliated with Coordinated Health were not fully disclosed and were out of line with the services offered.
Their lawsuit against CH Hospital of Allentown, trading as Coordinated Health and CHS Professional Offices of South Whitehall, and CHS Professional Practice of Bethlehem, was filed on behalf of themselves and others who were “misled and, charged” patient facility fees and procedure facility fees for non-hospital outpatient services.
The action sought a judicial declaration that the facility fees “are void and of no effect,” as well as a recovery of the sums charged to patients.
Settled The Matter Secretly
The plaintiffs’ attorney, James Scanlon of Milford, Pike County, said that a judge never certified the complaint as a class-action lawsuit. President Jim Tsokanos stated that Coordinated Health does not discuss litigation publicly.
Tsokanos claims that Coordinated Health publicly displays facility costs in patient notices, registration signs, outside clinics, and its website. He explained that facility fees are expenses charged for services given at a hospital-based outpatient department or site. Coordinated Health assigned them since its clinics are considered departments of the government’s main hospital. Tsokanos noted that the patients must pay for additional equipment, staffing, training, and building because the clinics are accredited and must adhere to hospitals’ same standards and rules.
Coordinated Health is obligated to issue one bill for the institution and another for the physician or health care professional under that model, known as a “provider-based” or “hospital-based” health care network, according to Tsokanos. He stated that some patients pay more at hospital-based outpatient sites for specific outpatient services and procedures, and their insurance will determine it.
Based on the lawsuit, Lychak operated by a physician in Bethlehem in a facility affiliated with, employed by, or part of Coordinated Health and CHS Professional Practice, but not on a hospital campus. He also underwent a physical examination and steroid injection, followed by an MRI and follow-up consultation.
The patient’s bill was $1,342. The fees computed as follows: $255 for the physician, $61 for the pharmacy, $369 for the patient facility fee, and $607 for the procedure facility fee even though the visit was a non-hospital visit and the treatment was performed in a doctor’s office and not at or near a Coordinated Health Hospital owned or operated hospital.
Lychak’s health insurance mandated that he covered 20% of medical expenses and was ultimately held liable for $39 of the physician’s fee and $511 of the facility expenses.
A Similar Outpatient Treatment Technique
McFadden had a similar situation, although his out-of-pocket payments were lower due to his insurance restrictions. There was no reasonable relationship between the patient facility fees and procedure facility costs that plaintiffs got compelled to pay for the services given the cost of any facilities used. The podiatrist conducted the same outpatient treatment technique at less than $150 for the visit and injection.
Lychak and McFadden had not alleged sufficient evidence that plausibly demonstrates that these charges were unconnected to the expenses of the services given according to court documents. They couldn’t claim financial losses because of the facility fees invoicing to them. After all, they hadn’t satisfied their annual insurance deductibles.
According to Mariella Miller, a spokeswoman for St. Luke’s University Health Network, there are no facility costs. The spokesperson of Lehigh Valley Health Network, Brian Downs, stated that patients might be charged fees if treated in hospital-based facilities like imaging, cardiac diagnostics, and rehabilitation.
