Facility Fee Right-to-Know Act: Frequently Asked Questions
Maryland's Facility Fee Right-to-Know Act, also known as Facility Fee Disclosure, effective July 1, 2021, requires hospitals to provide certain formal notifications and disclosures to patients, both oral and written, related to hospital outpatient clinic charges or facility fees.
Listed below are answers to some frequently asked questions to explain the processes UMMS clinics put in place to provide the required notice to patients.
What will be different when I schedule my outpatient clinic visit?
At the time of scheduling, the following information will be provided to you:
- That the services located in a hospital-based clinic may result in the patient receiving more than one bill, e.g.: one from the clinic and one or more from the provider(s);
- That alternative treatment locations that do not charge for facility fees may be available;
- That financial assistance may be available to patients who need assistance paying their bills; and
- That complaints regarding facility fee charges may be made to the Central Billing Office, or if needed to the Health Services Cost Review Commission (HSCRC).
Additionally, you will receive an estimate based on the information available at time of scheduling. A Summary Letter outlining the above and other pertinent information will be delivered to you either via MyPortfolio or USPS mail. This Summary Letter is not a bill.
What is included in the estimate?
Estimates provided at time of scheduling include hospital charges only. Estimates do not include physician or professional fees, or any unforeseen circumstances that may occur during your treatment.
Is the estimate the amount I have to pay prior to my appointment?
No. It is an estimate of the possible hospital-based charges for your care.
Do I have to make a payment when I receive the summary letter?
No. The Summary Letter includes an estimate and is not a bill.
Is the estimate the amount I have to pay out-of-pocket?
If you have insurance, your benefits will ultimately determine the amount you owe (including deductibles, co-pay, co-insurance, and out-of-pocket maximums).
This estimate is based on information provided at time of scheduling and is not a guarantee of what you will be charged. Your actual charges may differ from the estimated charges for many reasons, including the seriousness of your medical condition and the services you receive.
Do I receive a copy of my estimate?
Yes. A Summary Letter will be delivered to you either via MyPortfolio or USPS mail.
Do I have to sign anything when I come in for my clinic visit?
You will be asked to sign a form acknowledging that you have been provided the required disclosures at time of scheduling, including:
- That you may receive a hospital facility fee and a provider fee;
- That you were provided with information about the facility fees that will be billed for your appointment;
- That the fee could vary based on the services provided; and
- That your out-of-pocket costs will depend on your insurance coverage.
My medical needs require frequent visits to the hospital. Will I receive a Summary Letter with an estimate for each of these visits? Will I have to sign the Acknowledgement Form for each of these visits?
If you schedule a series of appointments, you should only receive one Summary Letter for the series. If, later, you schedule another series of appointments, you will receive another Summary Letter.
You will be required to sign an Acknowledgement Form once a month, typically at your first visit of the month.
If my estimate seems high, what do I do?
For clarification of your estimate, you can contact the clinic at which your appointment is scheduled or contact Customer Service at 410-821-4140.
If you have insurance, your benefits will ultimately determine the amount you owe (including deductibles, co-pay, co-insurance, and out-of-pocket maximums). Contact your insurance provider for coverage information.
I scheduled an appointment, but an estimate was not provided at that time. Will I still get an estimate?
There are instances where it may not be possible to receive an estimate at the time of scheduling; for example, sometimes a health care provider, rather than a scheduler, may schedule the appointment. In these cases, someone from our registration team will follow up to provide you with an estimate. You will also receive a Summary Letter via MyPortfolio or USPS mail.
Who do I call if I have questions not listed here?
Contact Customer Service at 410-821-4140.
Can I go somewhere on your website to get my own estimate?
Yes, estimates for frequently scheduled services are available here.
Please Note: The scheduler-generated estimates will be more targeted to your healthcare needs based on information from your provider.