waterworld
Semele & Zoezmom: Most insurance companies have an appeals process available so you can challenge the denial of coverage for the fee. If you go through the process of challenging it with the insurance company, you might get the fee covered, and the company might be more inclined to follow up with Highline (meaning, telling them to stop billing their insureds).
My reaction to this is that it could be illegal. As someone else posted earlier, most insurance plans require the health care provider to agree not to impose any fees on the patient other than the co-pay or deductible. The provider is required to agree to take what the insurance company will pay, and the provider can’t look to the patient to make up the difference if the insurance payment is lower than what the provider charges.
A few years back, there were a couple of class action lawsuits in Seattle against Virginia Mason and the UW Medical Center over “facility fees” that were being imposed on patients depending on which clinic the patient visited. For example, a patient might go to one VM clinic and get a bill for, say, $100 for the doctor visit, but if that same patient went to a different clinic, he or she would get a bill for an additional “facility fee” that might be hundreds of dollars on top of the $100 for the doctor visit.
Both cases resulted in refunds to thousands of patients who had been billed and paid the extra fees. However, I think the cases were settled out of court, in which case there won’t be a court decision with a legal holding in either case. I would not be surprised if the fallout from those cases is that hospitals and clinics like the Highline Urgent Care clinic are now giving patients advance notice of extra fees and requiring the patient to sign an agreement to pay, because they think that solves their problem.
But I tend to think that unless it is made very clear to the patient that insurance won’t cover the fee, which Highline apparently knows, then it is unlawful for Highline to impose the fees. It’s especially misleading to be imposing the fee in this manner when there is already a process for collecting a “deposit” from many patients. Patients are much more likely to be confused about what they are signing up for. And if this fee is just another way of jacking up the price of the visit because the clinic is not satisfied with the insurance payments, then it would be unlawful. (This is all just my opinion and belief; don’t rely on legal postulating in a forum.)
Unfortunately, these things usually just continue unless people take action, whether in the form of lots of complaints to Highline, or getting the attorney general to investigate, or getting a class action lawyer involved. Whether any of that will happen, who knows. But you can at least push your insurance company to either cover the fee or take on Highline on behalf of its customers.