Carle visit will bring second bill for many

Carle visit will bring second bill for many

URBANA — Going to see a doctor at Carle?

For many patients starting next month, that's going to mean getting two bills instead of one.

Starting June 1, some Carle physician clinics will become outpatient offices of Carle Foundation Hospital. So patients will get two bills — one from the doctor and one from the hospital.

The hospital bill will be a $205 "facility fee." But insurance coverage will apply, so that's not necessarily what insured patients will pay, according to Carle spokeswoman Jennifer Hendricks.

Carle officials say this switch to "provider-based" billing will help Carle remain in a financial position to continue providing health care for the community.

"It's a very difficult economic environment," said Dawn Walden, Carle's vice president of revenue cycle operations. "Carle is being proactive to make sure this gem we have in the Champaign-Urbana area is providing outstanding health care for years and years to come."

How provider-based billing will work at Carle:

The doctors will remain part of Carle Physician Group, and bill for their time, and the hospital will bill for its costs involved in the offices, support staff and supplies, Walden said.

Affected June 1 by the extra bill will be patients coming to Carle's North and South clinics on the central Urbana campus, which includes some primary care and specialty physicians.

Hendricks said some of the services affected include cardiology, digestive health, maternal fetal medicine, the South Clinic lab and the Expanding Children's Hearing Opportunities (ECHO) program.

Oral maxillofacial surgery will be excluded from the hospital fee, she and Walden said.

Starting July 1, Carle's Champaign clinics on Curtis Road, Mattis Avenue and Kirby Avenue will be included for the new billing charge, along with the Urbana clinic on Windsor Road, Walden said.

Some Carle physician clinics in communities outside Champaign-Urbana will be included in provider-based billing eventually, she said, but a decision hasn't been made yet on which ones.

And, Walden said, "we don't have a firm date when those might transition."

Carle's cancer center and radiology department were already converted to provider-based billing Dec. 1, 2012, and without much patient response, Walden said.

"We've had some patients call to ask to explain the bill, but really, it's been a very smooth process," she added.

How much patients wind up paying of the new fee will depend on their insurance coverage, according to Walden.

The "vast majority" of Carle patients have more than one insurance coverage, so they may well end up paying nothing more, she said.

One patient, Mike Swisher, 36, of Tolono, says he inquired about the new billing recently when his nephew got a letter in his bill about it.

Swisher said he called Carle and asked how much the other charge would be and was flabbergasted when someone in the billing office told him $205.

"It's a huge hit, especially for families that have high-deductible plans," he said.

That includes his own family, Swisher says.

Under his health plan, his family has a $6,000 deductible to meet before insurance helps pay, so the second bill would bump the cost of a doctor visit for him and his family — now $150 — to $355. Swisher said.

His insurer pays 100 percent for preventive services, Swisher said, but he doesn't know how that will be affected with the additional billing. If he has to begin paying a $205 charge for preventive services, he said, he plans to check out doctors at Christie Clinic, where he also has coverage.

Hendricks said the change to provider-based billing is a Medicare status allowed for integrated providers that offer both a hospital and physician services. It also allowed Carle to apply and be approved for a Medicare purchasing program that will reduce the costs on some drugs used in hospital outpatient settings, she said.

All health care providers are feeling the impact of declining reimbursements from private and public insurance payers, rising costs and declining revenue from patients who can't afford to pay, Walden said.

"We want to stay ahead of the curve," she said.

Carle began notifying patients in mid-May about the change in letters being inserted into their bills, Walden said.

Patients will be called in advance of their appointments to preregister with the hospital, "so when they come in to see the doctor, it's a quick stop at the front desk," she said.

Sections (2):News, Local
Topics (1):Health Care

Comments embraces discussion of both community and world issues. We welcome you to contribute your ideas, opinions and comments, but we ask that you avoid personal attacks, vulgarity and hate speech. We reserve the right to remove any comment at our discretion, and we will block repeat offenders' accounts. To post comments, you must first be a registered user, and your username will appear with any comment you post. Happy posting.

Login or register to post comments

FRO wrote on May 30, 2013 at 8:05 am

This double billing is a crock of &%$#.  Now they are going to jack the price up even more.  Carle is a joke when it comes to billing.  They just changed their billing practice a couple of years ago and still is not up to par.  So now we have to pay for the outlandish dr visit and then pay to go to the facility is pure crap!  Remember when a dr office visit was 35 dollars.  See how much they have incresded a visit over the years.  Still get the same amount of service but now instead of 35, it is 135 or more. 

larbear wrote on May 30, 2013 at 8:05 am

Nice! Carle doesn't want to pay their property tax bill but they want you to pay to sit in their waiting room for an hour so that their doctor can spend 10 minutes with you.

prp wrote on May 30, 2013 at 10:05 am

This is happening BECAUSE of the tax situation.  Carle has changed its clinic offices to be part of the hospital so that they do not have to pay property tax on those buildings.  As a result, they now have to charge what they would charge if the procedure were performed at the hospital, hence the extra bill.

So not only are their expenses going down (less tax payments), their revenues are going up!

Nice way to make a living (if you can rig the system to allow it).

A Very Busy Mom wrote on May 30, 2013 at 8:05 am

Unfortunately, I will now be looking for a provider outside the Carle network.  This is unbelievable - eventually no one is going to be able to afford healthcare.

vcponsardin wrote on May 30, 2013 at 9:05 am

People complain about the high cost of a university education, it's about time people looked into the outrageous costs of medical care.  Just spent 2 days in Carle and while my insurance will cover almost all of it, the bill still came to $31,600.  That's simply outrageous.  There was no surgery, just two tests and two days of observations.  That's it.  And the bill is equal to a full year of tuition and costs at the University of Illinois.  Something is very very wrong here.

45solte wrote on May 30, 2013 at 10:05 am

'Gem' for whom? lol. Cash cow for Carle to stick it to the people who actually pay for services so that Carle can provide enough 'free' care to 'the community' in order to maintain it's tax-free status.  If you really want to provide 'free' care, have your doctors, etc.  volunteer their hours instead of essentially making everybody else pay for 'the community.' Do right by your tax-free status and pass the savings on to ALL of 'the community.' Otherwise there's going to be nobody left to pay for your 'free' Community 'Care.' Then again, get out of Dodge, anyway, if you really want good medical care.

45solte wrote on May 30, 2013 at 10:05 am

You are not even seen at the facility for which you are paying a $205 facility fee? Have I really got that right??? I must be missing something. Clue me in, people.

Irishgal wrote on May 30, 2013 at 5:05 pm
Profile Picture

No, the facility fee you pay will be for the facility where you are seen.

45solte wrote on May 30, 2013 at 10:05 pm

'The doctors will remain part of Carle Physician Group, and bill for their time, and the hospital will bill for its costs involved in the offices, support staff and supplies, Walden said.'  Sounds like a fee paid to the hospital even at other locations...

'Starting July 1, Carle's Champaign clinics on Curtis Road, Mattis Avenue and Kirby Avenue will be included for the new billing charge, along with the Urbana clinic on Windsor Road, Walden said.'

So the doc bills should be lower, then??? given that current billing includes those overhead costs already?

Lostinspace wrote on May 30, 2013 at 10:05 am

Current billing includes doctors' fees and costs for "offices, support staff and supplies."

Logically then, once non-physician costs have been separated out, the bills for doctors alone will be lower than the current combined billing.


Danno wrote on May 30, 2013 at 1:05 pm

Correct. This is not 'new', per say. 2-3 yrs ago, after many test procedures, overnights in observation, etc.; my billing was separated. I requested a detailed report, and it was quite accurate. One part was to the Physicians Group, the other to the Hospital. On another note, from my understanding, as explained to me following my wife's recent major surgery, from the surgeon, it's necessary from a legal, contractual, insurance, AMA and, Federal (all separate) points of view. Likely due to the EXPLOSIVE increase in malpractice suits. It is necessary to separate a doctor's advice/care/recomendations from that of the physical doings of a hospital; e.g. some overburdened nurse making a common error, a faulty oxygen tank, a somehow-screw-up-in prescription application, etc...etc...Anyway, say you're billed for an 'Urinalysis', and you know damned well that your recent 'visit' didn't consist of such a thing, question it, it will be resolved. Per above posts; you think health care is expensive now? Just wait.

Bulldogmojo wrote on May 30, 2013 at 10:05 am

Now if only the NG would do some investigative journalism on Christie clinic's corrupt and dysfunctional billing system. Seriously

gftst wrote on May 30, 2013 at 1:05 pm

I would take issue with the statement that the vast majority of patients have more than one insurance plan coverage. A lot of people dont even have one let a lone two. Depending on how insurance companies bill/pay for this fee its essentially doubling what the cost of an office visit will be. Like someone said previously soon no one will be able to afford healthcare or youll pay for the healthcare but not be able to afford anything else.

Danno wrote on May 30, 2013 at 3:05 pm

It's not doubled. If you're troubled, I'm certain that Prussing is on it on the double;)

JeffCarroll wrote on May 30, 2013 at 2:05 pm

I will be ending my 20 year relationship with Carle and Health Alliance over this. Provena and Blue Cross, here I come.


ERE wrote on May 30, 2013 at 3:05 pm
Profile Picture

Ease up all you using this article to trash on Carle. This type of billing is standard nearly everywhere. The facility fee is MUCH higher in many other hospital systems.

$205? Why that's A LOT LESS than most Illini basketball tickets are going to cost in the new State Farm Center. You health is worth a hell of a lot more than a basketball game. And none of the docs make what the coach does. I don't hear you all griping about that. 

Sure, it's a significant expense but that is what the level of health care Americans want costs. 

jdmac44 wrote on June 05, 2013 at 4:06 pm

It's been something like two or three years since I've been to a Illini game and that was because someone had extra tickets and if tickets go that high, that'll be the only way I'll ever see another live game.  I already miss most games because I refuse to get BTN and I even cut cable.  In any case basketball is entertainment.  It's not really the doctors, it's their employers who are sucking up all the profit.

mankind wrote on May 30, 2013 at 4:05 pm

Surely somebody in the healing profession is violating a sacred oath when the hospital pulls a stunt like this. Doubling the bill will discourage people from visiting the doctor until it's an absolute emergency. How many times will it be too late?  

Irishgal wrote on May 30, 2013 at 4:05 pm
Profile Picture

I am a patient at Carle and will remain a patient at Carle.  I am disturbed by some of the comments posted by my fellow health care consumers.  Placing any blame for the increasing costs of health care on the physicians/health care providers is ridiculous.  This would be like blaming an employee at McDonalds for an increase in the price of a hamburger.  Health care is a business.  With any business, the financial structure has to adjust to remain viable in the current economy.  Simply because in 1950 you may have paid 10 cents for a hamburger, you would never expect to pay only ten cents today, nor would you expect to go through the drive-thru and get your meal for free.  I would be willing to bet most would not think twice about paying $5 for a special burger at a local fast food restaurant, but when it comes to taking care of your health, many feel it should cost them nothing.

I do not like the idea of any increase in cost for anything I do.  I too would rather spend my hard earned money on something other than my health care.  However, I too am one of those people that should eat healthier, exercise more, get a good night's sleep, and in general do things that are better for my health.  Since I don't do any of these things, I am thankful to have Carle in my community to manage the health care issues I have created for myself...paying for non-essential things.  We are largely a nation of over indulgence then complain about the rising costs that occur from the need to care for this over indulgence.

Carle is doing nothing different than Mayo, Cleaveland Clinic, and OSF.  Carle could have done this two years ago when the hospital and clinic merged.  Carle offers Community Care to a multitude of patients and their families.  For those who are concerned about the increase in cost, I encourage you to contact Carle and inquire about Community Care.  Carle supports many initiatives within our community as well.  As a consumer, we all have the choice of where we go for service- even if our insurance carrier says otherwise.  It may mean a greater out of pocket expense for the consumer.  All choices carry consequences-good or bad.  For those Carle patient readers choosing to go elsewhere for their health care, please be reassured that when you need them, Carle will still be there.  I for one will remain a Carle patient so I can continue to receive the excellent care that I always have. 

residentofcu wrote on May 30, 2013 at 6:05 pm

Do I understand this correctly? What we pay right now for an office visit (colds, sore throats, etc) is $150.00 dollars. Starting July 1 an additional $205.00 fee will be added.

I don't see how anyone can think $355.00 for an office visit is acceptable. No matter if it is covered by insurance or you pay out of pocket!

Danno wrote on May 30, 2013 at 6:05 pm

Allow me a question. People actually consume valuable health care provider's resources/time for a 'cold', a 'sore throat'? Imagine the time/talent/$ wasted. C'mon, most of the time, by the time you get an appointment, you're symptoms are over. If it's a lingering thing, yes, look into it. But really, a 'cold'? Being a hypocondriac would require a psychiatrist.

residentofcu wrote on May 30, 2013 at 8:05 pm

really. that's what you want to focus on? Yes. the last time I went to the doctor was for a cold that lasted over two weeks and was not getting better.... no hypocondriac's in this family...hubby did not even have a family doctor in CU until he was 40. We pay out of pocket for each visit so we limit them!   $355 is out of line for a regular doctor visit for family medicine.

itazurakko wrote on June 05, 2013 at 6:06 pm

Plenty of places in the world you do, yes. Just walk down the street, see a clinic, pop in there, show your national health card, get your meds, be done with it.

In the US military system too, plenty of people go to the hospital when they have a sore throat (or their kids do) to test for strep, it's not that outlandish. You see whatever doctor (or nurse, depending) is on call.

ERE wrote on May 30, 2013 at 6:05 pm
Profile Picture

Where's Rob McColley?? I think this forum needs a comment by Rob to bring it from the ridiculous to the sublime.

I am certain that many of these commenters who are so negative on Carle also would expect that EVERYTHING be done for them if them were admitted to the hospital. C'mon-things like immediate cardiac caths,  a fully staffed ED, a Level One trauma center, etc., cost A LOT of money!  Why is it that so many expect health care to be free or cost little? I can hardly thing of something more worthwhile. How many minutes (surely not an hour!) would $205 get you with one of the local law firms? 

Patients with insurance don't pay anything close to the amount billed. Those who can and have chosen not to obtain health insurance have that decision to thank when they rack up large hospital bills. If you don't get home insurance and your home is damaged, you have that decision to thank for the bill. Those who cannot afford health insurance or who are denied coverage by health insurance companies-who are the real profiteers of our current system along with big pharma-can be thankful with the rest of us that Obama was able to pass at least some sort of national health care. 




45solte wrote on May 30, 2013 at 9:05 pm

How about you speak for yourself.  Carle is out-of-network for me now and there is no comparison when it comes to the care I have received out of Champaign (including the billing rates/amounts being lower). The ER you laud failed me with lasting consequences. I have spent 50% of my personal income on medical expenses (which includes COBRA premium$) for the past couple of years since Carle ED gave me the GOMER Tx (followed by Christie ED). As for Obamacare. Just wait! There is nothing in it to be thankful for. Until you have lived socialized medicine, you have no idea what you are advocating for. NO CLUE. BTDT. People are in for a shock (as things eventually end up single payer, by design). 

45solte wrote on May 30, 2013 at 9:05 pm

Yes, healthcare is a worthwhile thing to spend money on. But quality of care matters. Does 'meh, it's probably just ...' qualify as part of a differential diagnosis standard of care? Are decisions about your health based upon outdated and/or inaccurate medical information acceptable as a standard of care? Standards of care are what give your health the best chance. Absent them, it's not worthwhile spending your money on healthcare.

sweet caroline wrote on May 30, 2013 at 7:05 pm

I'm so confused.  Carle says: The hospital bill will be a $205 "facility fee." But insurance coverage will apply, so that's not necessarily what insured patients will pay, according to Carle spokeswoman Jennifer Hendricks.

Exactly how MUCH insurance coverage will apply?  100%?  50%?  5%? 

Will it be the same for State employees as for other insured people?  What about the State retirees?  Nobody at the State offices seem to have any idea as to how much of the $205 facility fee they will have to pay in addition to their co-pays.  I'm considering saying good-bye to Carle and going with one of the other State plans. 

Irishgal wrote on May 30, 2013 at 7:05 pm
Profile Picture

Typically, whatever your current insurance split is-ie. an 80/20 plan, is what you could expect to pay for the facility fee.  If you pay a 20%/$20 co-pay for an office visit, you would likely expect an increase in your co-pay to be around $40.  What your portion of responsibility will be is determined by your insurance carrier.  As a health care consumer, I would recommend contacting your insurance carrier or your plan provider and ask them based on your plan coverage what will your out of pocket expense be.

sweet caroline wrote on May 30, 2013 at 8:05 pm

Thanks, Irishgal.  You sure seem to know the details.  Do you work for Carle?

Irishgal wrote on May 31, 2013 at 3:05 pm
Profile Picture

Read up on Provider based billing when OSF bought Carle in Bloomington.

prp wrote on May 31, 2013 at 9:05 am

Except for a lot of (insured) people, their plans pay for 80% up to UCR (usual, customary, resonable).  If Carle charges over whatever the insurer considers "fair" it is up to the client to make up the difference.

I'm sure if you're with Health Alliance, as it is kinda sorta part of Carle, things will be covered better than if you have a different private insurer.

A Very Busy Mom wrote on May 30, 2013 at 9:05 pm

I wonder how this will affect individuals who have a co-pay for an office visit?  You pay the office visit co-pay and then the $205.00 will either go to your deductible and you will be responsible for the entire amount or it will go to your out of pocket and you will be paying the 20% coinsurance.

As health care costs have increased, individuals have had to make hard choices on their health insurance taking a higher deductible and higher out of pocker, this will be an additional cost that many cannot afford.

I understand that there is Community Care, but if you are lower middle class there is no discount available for you and you are stuck in a no win situation.

Carle has great physicians, but I really do feel that they will be pricing me out of their services.  I will have to find another primary care physician who is outside the Carle network.  And that is sad.

danrice56 wrote on May 31, 2013 at 8:05 am

I'm simply astounded by those complaining about the complainers. Their responses amount to "Costs go up. Deal with it. What do you think this is, 1950?" And, "Hey, if you have insurance, it's not like *you* are paying that additional 205.00 facility fee, that will be on your bill above and beyond the cost to see the doctor."


Yes, costs go up. But a single aspirin pill can cost around 25.00. That's more than expected inflation. That's highway robbery.


And, even *with* insurance, the total bill for a doctor's visit plus a facility fee, will push the cost out of reach for many. Then you can surely expect both the doctor's fee and seperate facility fee, already high, to go up even more. Even with insurance, it will eventually be too much of a burden for many.


I see no reason why someone, already paying a high fee for five minutes of a doctor's time, should not have just reason to complain about now paying even more, even if insurance covers much of the additional fee.

prp wrote on May 31, 2013 at 9:05 am

Hear hear!

sweet caroline wrote on May 31, 2013 at 9:05 am

We think it's bad now....just wait until this time NEXT year when obamacare is in full effect. 

ERE wrote on May 31, 2013 at 1:05 pm
Profile Picture

Well, I'm astonished by all the complaints about those complaining about the complainers! I thought such negativity was not possible in a cool enlightened community like Urbana-Champaign. Normally, you'd only expect that on the East Coast where it is a way of life.... 

RealisticLady wrote on May 31, 2013 at 2:05 pm

I think many of the people that have commented fail to realize that Carle is not the only facility to charge this facility fee.  In fact, it is becoming more common across the country.  Most hospitals have done this to help supplement their income to counter-balance Obama care.  It was realized the insurace companies would pay this fee--so why wouldn't Carle charge it?

C-U is already on the attack and will use anything to put Carle in a bad light.  C-U wants Carle to continue to provide millions of dollars in free services AND pay millions in city taxes.  If the city has it's way, we (the public) will pay for it one way or the other.  There will be a facilities charge, higher rates, or the city will see a reduction in free benefits.

It is sad that so many of these comments also do not know the facts about the Carle merger that took place a few years ago.... but of course, the whole story was not published--only the parts that would make Carle look bad and "sell" the story.  The hospital and clinic HAD to merge for legal reasons.  The government mandated that entities such as theirs could not operate as separate companies and refer patients solely to the other.  It was not by choice!  If Carle had known this would have happened, I doubt they would have built two new locations only to move many of those doctors back to the main branch once the merger was complete.

Trust me, I am not one to normally defend Carle--but the money does have to come from somewhere.  So while people threaten to go to Provena, Covenant, or any other provider--just wait.  The fee is already there or will be soon.  And before you condem them completely, remember they are the second largest employer in the county.  Less money taken in = less money for employees = less Carle staff to take care of your aches and pains.

Just some food for thought.



Irishgal wrote on May 31, 2013 at 3:05 pm
Profile Picture

VERY well said!

bpercival wrote on May 31, 2013 at 4:05 pm

Here is a FAQ for the misguided, also key points left out of story.


Which Carle physician offices are Provider-Based? Currently, the following Carle Physician Group locations are provider-based:

Carle Cancer Center (converted in 2012)

Carle Radiology (converted in 2012)

All Carle physician offices located in the North and South clinics on the Urbana main campus except for Oral and Maxillofacial Surgery

Cardiology services at the main campus in Urbana

Maternal Fetal Medicine and Maternal Fetal Medicine OB Sono in Urbana

Digestive Health Center

South Clinic Laboratory, Urbana

Expanding Children’s Hearing Opportunities (ECHO)

Most of the remaining office locations will be converted to Provider Based Status later this year. Effective July 1, our clinics located at Champaign on Curtis, Champaign on Kirby, Champaign on Mattis, and Urbana on Windsor will become outpatient departments of the hospital and convert to Provider Based Billing also. Remaining locations will convert later in the year. The Mattoon-Charleston location will not convert as it is not eligible under the Federal rules.

Why is Carle converting to this model for most of its physician office locations?

The rising cost of health care and lower reimbursements prompted Carle to make this change for its physician office locations. The Medicare-approved Provider Based model ensures Carle is compensated fairly for services provided and allows Carle to participate in a federal drug purchasing program that will help lower to the total cost of care.

Like all Illinois hospitals, Carle is experiencing significant reductions in reimbursement. The following reductions in revenue are adding significant pressure to Carle’s ability to preserve the level of healthcare all patients deserve.

Affordable Care Act Cuts: $80 million over 10 years to Carle

Sequestration Cuts: $15 million over ten years to Carle

Regulatory Coding Cuts: $12 million over 10 years to Carle

Outpatient reimbursement cuts: $1.6 Million over 10 years to Carle

Medical Education Cuts: $35 Million over 10 years to Carle

Illinois Medicaid 3.5% rate reduction cuts: $2 million in 2013 alone to Carle

State of Illinois Excellence in Academic Medicine program eliminated: $2 million in 2013 to Carle

Carle is taking proactive steps to ensure high-quality care is available to the residents of east central Illinois now and in the future. By converting to the provider-based model, Carle is ensuring it is reimbursed fairly for Medicare services. By applying for the 340B Drug Purchasing Program, Carle is trying to reduce the supply cost of providing care to patients.




Irishgal wrote on May 31, 2013 at 5:05 pm
Profile Picture

Great clarification and summary!

serf wrote on May 31, 2013 at 8:05 pm

You two are definitely Carle employees.

parkmymeterelsewhere wrote on June 04, 2013 at 10:06 am

And you work for the Goad Lady.

mgg wrote on September 11, 2013 at 7:09 am

If Carle had any sense of decency, they would post along side these numbers their income statements.  For a hospital that is constantly whining about costs, they are constantly adding lavishly appointed buildings that have to be costing in the area of $100 Million dollars.  Facility fees is just another way to game the system.  That "every hospital does it" just means it is profitable. Isurers are in on the game too.  They negotiate lower rates for payments but patients end up still being charged the full rate for their portion of the bill.  Carle is buying up dr facilities in the area and the facilities fee must be quite a gold mine.  How about an honest answer to the question: do drs fees go down because facility fee is now separate?  I'm betting it doesn't which is all the confirmation one needs to call this a callous money grab.


Sandy wrote on June 01, 2013 at 1:06 am

I checked with Health Alliance today and spoke with an angry employee. Not only did they not get any advance warning of this at all, but the fee will apply to Carle employees as well. The early word is that HMO fees won't be changed, but they're still trying to figure out what is going on. She also reminded me that state employees will be able to use Christie doctors.

The facilities fee is absurd. Traditionally a doctor's fees covered the expenses of his practice -- his time, plus the overhead necessary to keep his office open. Is Carle really trying to argue that the enormous fees it already charges do not factor in overhead? 

The really offensive thing is that they are using the amount of charity care they provide to justify not paying property taxes, and then they argue that they have to assess a new fee because of the money they lose providing charity care.  This doesn't sound like any charity I've ever heard of -- it sounds like a company trying to maintain its profit.

I've been a patient since its was CarleCare, and most of my doctors have been excellent. They aren't the jokers proposing this fee, and they aren't responsible for the charity care issues (or their previous practice of taking debtors to court).  It's the administrators we have to thank for the current mess, not the health care providers. 





dd1961 wrote on June 01, 2013 at 6:06 am

No, it is what is to come in 2014 that is to blame.  This is just the tip of the iceberg I am afraid.

serf wrote on June 01, 2013 at 7:06 am

You hit the nail on the head, Sandy.  This is a money grab, pure and simple.  Carle makes millions, if not tens of millions, in profit every year.  They know they have a near monopoly.


DD1961, Obama is not the root of all  your problems.  I know that might make your head hurt.

dd1961 wrote on June 01, 2013 at 10:06 am

You make a lot of assumptions don't you.  I have actually done a lot of reading on the health care act, including the act itself.  Have you?

sweet caroline wrote on June 01, 2013 at 11:06 am

You're right, dd1961.  And all those who are brainwashed by Obama will pay the price just like the rest of us who've known all along that obamacare is a disaster in the making.  I know democrats who already vocalizing their regret at having voted for him the second time around.

1conservativemom wrote on June 01, 2013 at 1:06 pm

Quite the assumption that patients have more than one insurance coverage!

Now to find a new optometrist for my daughter...saw one at Carle for 16 years (since she was 2) No insurance....paying "out of pocket"  now means a cost of $345 for an eye exam....simply not happening.


dd1961 wrote on June 01, 2013 at 2:06 pm

Many studies have indicated that the health care costs will go up in reaction to the implementation of the health care act. The 800K cut in medicare is from the doctors and facilities getting reimbursed less.  Of course they are reacting by raising costs elsewhere, such as where they can get paid by insurance.  Of course insurance is reacting by raising their rates as well, within what the law allows them, because they do have a cap on what they can make per premium(which is a good thing IMO).  What the law does not address is the cost of health care.  It addresses making sure everyone has insurance, but the cost is passed on to the rich(which many people love) and the middle class(which is unfortunate). 

Perhaps after  rocky start, it will work, only time will tell. Unfortunately, I have very little faith in the state of Illinois which is responsible for the implementation of the exchanges.

dd1961 wrote on June 01, 2013 at 2:06 pm

Many studies have indicated that the health care costs will go up in reaction to the implementation of the health care act. The 800K cut in medicare is from the doctors and facilities getting reimbursed less.  Of course they are reacting by raising costs elsewhere, such as where they can get paid by insurance.  Of course insurance is reacting by raising their rates as well, within what the law allows them, because they do have a cap on what they can make per premium(which is a good thing IMO).  What the law does not address is the cost of health care.  It addresses making sure everyone has insurance, but the cost is passed on to the rich(which many people love) and the middle class(which is unfortunate). 

Perhaps after  rocky start, it will work, only time will tell. Unfortunately, I have very little faith in the state of Illinois which is responsible for the implementation of the exchanges.

rsp wrote on June 01, 2013 at 5:06 pm

It's real easy to blame the new health care law and Obama and any of another things. Carle has been making these plans for a long time. They are doing what other places are doing that is really profitable.

All of Carle's plans over the years have been geared toward making the most money, from the additions they have added on and how they bill, to going nonprofit. 

dd1961 wrote on June 01, 2013 at 9:06 pm

Interesting article.

There was an article on TV about a surgery center in, I think, Oklahoma.  It was jointly owned by the surgeons, and they posted all their offered procedures and the costs on line.  There was no negotiations on price, what was posted was what you paid.  So if you needed a knee replacement, it is right there what the total cost is.  The prices were competitive with the local hospitals.  The story pointed out that the hospitals would not give a single answer how much a surgery cost, so it was difficult to find the actual cost from them.  I thought it really showed how frustrating dealing with medicine is, and a way to make it less frustrating.

danrice56 wrote on June 04, 2013 at 3:06 pm

To those who said this is not unusual, not out of the ordinanry, Carle is simply doing what many, if not most, hospitals already do.



So the argument is, because most do something that hurts another group of people, in this case patients, if one more joins in the fray, there is nothing to complain about.


If most, even if everyone does something, that does not make it right  or acceptable.


This move may be greed on Carle's part, or it may be neccessary on Carle's part, but whichever, the idea, whenever it is put forth, and I've seen it put forth often, that if everyone is already doing something, there is nothing wrong with others doing likewise, is not a morally acceptable postion. Each action must be judged on the facts behind it, not mere precedent.

Also, the idea that this is being done so Carle can be able to continue to provide the best care possible. While I can see how additional fees can pay for additional staff, better equipment, etc, let's look at those who will no longer be able to afford Carle due to these fees. How do additional fees assist you in providing the best care possible, when those same fees bar some from enterting your doors?

tlbrown wrote on June 14, 2013 at 11:06 pm

If Carle is losing money, it's because they don't know how to effectively use their own Community Care program. They write off huge bills for people who should be put on a payment plan. I know personally 2 people who could pay their bill but obviously, Carle doesn't check everything out. There is no way someone with double insurance coverage, should have the remainder that is NOT covered by their insurance, paid for by Community Care. The other one never had to pay a penny of a nearly $36,000 hospital bill but then went and bought a new car. Disgusting!!!!

sasako wrote on October 13, 2015 at 10:10 am

My mother went in for a 15-20 minute office session with Carle Psychiatry this summer. Between the Carle Foundation and Carle Psychiatry, the total bill came to $600. $235 from the Carle Physicians Group  and another $365 for a “facility fee” from Carle Foundation Hospital. This amounts to a pro-rated $1,800-$2,400/ per HOUR, which likely exceeds even the highests paid consultants or lawyers, in my experience. It breaks down to $30-$40/per MINUTE. All this for a session in the psychiatrist’s own office where there is no special medical equipment involved. Although the insurance payment and provider discount reduced some of the amount due, my mother still owes approximately $275 for this 15 minute appointment, which must be paid out-of-pocket since the insurance will not cover it. When I contacted Carle Billing, they said this is standard procedure and the standard amount. THIS IS SIMPLY OUTRAGEOUS. I used to give the benefit of the doubt to Carle as a hospital and organization but now agree with those who are have the anti-Carle signs in their yards.  No matter how much "charitibal medical care" Carle claims to provide to the community, to charge or pass on the cost of this care while skirting paying their fair share of property tax is corporate greed, pure and simple.