Prognosis: Profits

In medical offices, new facility fees draw anger

Alice Ligon, a Cary real estate appraiser, was referred to Rex’s Pain Management Clinic in 2009 for neck pain from a degenerated disk. At her first visit, a doctor recommended steroid injections. She returned another day for the injections, which took a few minutes. The nurse asked her to stay seated for 10 minutes in case she got lightheaded, she said.

The doctor billed her $150 for the first visit. The second set of bills was the shocker. Her doctor billed her $425: $325 for administering the shots and $100 for the office visit. Then, Rex charged her $569.75: The drugs cost $52.75; the pain clinic cost $301; the recovery room was $216.

Ligon was livid, feeling she was being double-billed for the $100 office visit and the $301 pain clinic. But the worst was the “recovery room,” where she remained seated for 10 minutes in the same room.

“Rex charged me $200 and more just to sit in the same chair and in the same room while the girl did stuff on the computer,” Ligon said. “I got screwed.”

Rex told her on both visits that her insurance covered her care, Ligon said. But Blue Cross paid only $15.17 on the first visit, saying the procedure hadn’t been authorized.

She filed a complaint with the state Attorney General’s Office. Rex’s response: The fees were accurate and appropriate.

Ligon paid the entire Rex bill of $569.75. Given that the hospital’s costs are 30 percent of charges, Rex made a profit of $398.82. Ligon also paid the doctor $535.96 for the two bills that totaled $575.

“The consumer has nowhere to go,” Ligon said. “If you don’t pay, the hospital reports you to collections, and your credit is ruined.”

After The N&O asked about Ligon’s case, Rex changed its billing policy, combining the pain clinic charge ($301) and recovery room charge ($216) into one charge of $495, a reduction of $22. The policy only applies to future cases; Ligon did not receive a refund.

Staff writer Joseph Neff

Related stories from Raleigh News & Observer