Christine McConville, Boston Herald, August 31, 2010 Any day now, UMass Memorial Medical Center CEO John O’Brien will receive a quarter in the mail. It’s what Dianne Cooper Bridges thinks is a fair price for sitting in an exam room at the Worcester hospital for a few minutes. The Lenox woman has already paid $233 for her doctor’s visit. Now she’s fighting a second $133 bill for what she calls room rental. “It’s completely unacceptable,” Bridges told the Pulse. “It’s just one more way they reach into our pockets.” Virtually every major Boston-area hospital charges a separate facilities fee when a patient sees a doctor at an office inside a hospital. “This is true if you go to the emergency room, have elective surgery or visit a doctor in a clinical space,” said Rob Brogna, spokesman for the University of Massachusetts Memorial Medical Center. “One bill is for overhead, and the other is for the physician,” he said. But most in Massachusetts, where more than 97 percent of residents have health insurance, aren’t familiar with the fee. Their itemized bills are usually passed on to insurers, who generally foot the bill. “I thought the billing department made a mistake,” Bridges said. A self-employed designer without health insurance, she pays her health care costs in cash. She’s also hit with an occasional fine for not having any insurance. So before she made her doctor’s appointment, she called UMass to find out how much it would cost. A routine consultation - with no tests or procedures - would run between $200 and $300, she learned. So she was baffled when, weeks later, she received two separate bills. “I don’t pay a chair fee at the hair salon or a room rental fee when I see my accountant,” she said. “And why didn’t anyone tell me I would be charged twice?” Because of patient confidentiality rules, Brogna could not say why no one told Bridges about the dual fees. Boston University public health professor Alan Sager - who has called facility fees “a tax on the sick” - says Massachusetts hospitals make at least $100 million a year from these fees. Sager reaches that conservative number by taking the 20.5 million outpatient visits that Massachusetts hospitals were paid for in 2008, and cutting it in half. Then he figures that hospitals charge $10 for the remaining 10 million visits. Of course, for Bridges, the facility fee was $133, and she’s still not sure what it covered. Bridges decided it was time to send O’Brien a quarter after she was told the bill helps cover the cost of tissue paper on the examination table. “He can use the quarter to pay for the clean piece of tissue paper,” she said. “And if I’ve overpaid, he can keep the change and put it in his retirement account.” © Copyright by the Boston Herald and Herald Media.