This is an archived article and the information in the article may be outdated. Please look at the time stamp on the story to see when it was last updated.

CASTLE ROCK, Colo. (KDVR) — When it comes to facility fees, Brittany Tesso said fool me once but never twice.

“My first experience was shame on me right, because I didn’t know about facility fees. The second time, ‘Hey, let me give them a call,'” said Tesso, a Castle Rock woman with two young children.

When her 4-year-old son was evaluated last year for food allergies she was forced to pay a doctor’s fee of $650 plus $847 dollars as a facilities fee to Children’s Hospital Colorado, even though it was a telemedicine visit conducted online.

If a doctor works for a hospital instead of themselves at a private clinic, patients can face a facilities fee even if the patient never steps inside the hospital facility.

“I think that’s ludicrous. I shouldn’t be charged if I didn’t use the facility,” Tesso told FOX31 Problem Solver Rob Low.

Recently, Tesso’s pediatrician recommended her son see a gastroenterologist so she called Children’s Hospital Colorado to make an appointment.

But this time she knew to ask what the facility fee might be first and was told even after her insurance kicks in, she would still be liable for a $994 facility fee.

“I just had to keep my cool and say no thank you, we’re going to find another provider,” Tesso said.

Tesso found a gastroenterologist in Colorado Springs where she will only have to pay a copay of $50 because the doctor’s practice is private and not owned by a hospital.

“In that situation, it’s very difficult to justify why the cost to a patient would be so much higher at a hospital-owned clinic than it would be at a private physician clinic,” said Randal Schultz, an attorney with Lathrop GPM in Overland Park, Kansas.

Schultz represents small private doctor practices that have not been bought up by hospitals, so they don’t charge facility fees.

“Obviously, the consumers are paying a lot more money when they go to the hospital-owned clinic,” said Shultz. “What that’s done is caused the hospitals to buy primary care groups all over the country.”

The CEO at one Denver private practice emailed the Problem Solvers after our first story on facility fees writing about the difference between her clinic and hospital-owned clinics:

“The same physician can have a private practice office and see you for breast cancer at their private location and it will cost you a $20 copayment. Then that very same doctor can see you in a “hospital-based clinic” and you will have to pay the $20 plus the $500 facility fee. Same doctor, same diagnosis, same treatment, but two very different costs. For a while now, but certainly since COVID, private practice physicians have struggled to keep their practices afloat. We don’t have the money or resources that big hospitals do and our reimbursement from the government payers continues to go down each and every year. In 2022, my doctors are taking a 4% decrease in revenue from Medicare. It gets harder and harder to keep our doors open and a lot of private practice doctors end up selling out to hospitals,” the doctor, who asked to remain anonymous, said.

When Problem Solver Rob Low asked Randal Schultz if he was worried that privately-owned doctor practices are going to die off he responded, “You know, I do worry about that.”

In the case of Brittany Tesso, she will have to drive all the way to Colorado Springs for her son to a private gastroenterologist but since she lives in Castle Rock it’s not much farther than driving to Children’s Hospital Colorado in Aurora and well worth it since she won’t have to pay the expensive facilities fee.

“Absolutely, absolutely worth it,” said Tesso.

Both Children’s Hospital Colorado and the Colorado Hospital Association have told FOX31 facility fees are appropriate because they pay for the clinical staff and investments in new technology and that hospital-owned practices have to meet the same regulations as actual hospitals.

But it should be noted there are no regulations in Colorado that limit the cost of facility fees. Hospitals charge whatever they want though contracts with insurance companies place a cap on how the insurance provider will pay, but that often still leaves hundreds of dollars in facility fees for the patient to pay.

Critics like Shultz say facility fees have become a cash cow used by hospitals to buy up private clinics that can’t afford to pay their doctors as much as a hospital can.