DALLAS (CBSDFW.COM) – A visit to the doctor today could cost you thousands of dollars next year. More and more people are getting big bills, months after their appointments, for a little-known fee. The charge isn’t for your doctor — but the building.

Marissa Hernandez was just 17 when she developed a UTI last year. Hernandez was too young to use the health clinic at Texas Woman’s University, where she was a freshman. A friend’s mother suggested First Choice Emergency Room. In 30-45 minutes she was diagnosed and given two prescriptions. But insurance didn’t cover the entire bill. “It was $668 and I had to pay it in full.”

hospital bill Facility Fees Costing Some Patients Thousands

But the real sticker shock came a year later, when Hernandez received a second bill for a $3,065 facility fee. Hernandez says there is no way she can afford to pay. “I could pay for two semesters with that. That’s a whole year of school… for a 30-minute doctor visit.”

UT Dallas professor Keith Thurgood says most people still confuse a free-standing emergency room with an urgent care center. “You can’t go to an emergency room and expect to pay urgent care prices. They are 90 percent more expensive.” He says the facility fee covers the overhead of managing the ER.

But hospitals can charge facility fees too. And they can charge patients for going to any office affiliated with the hospital, no matter where it’s located.

Lewisville resident Rachel Anderson says she learned that the hard way, when she went for neurological tests at a doctor’s office at Medical City Denton. She says she asked about the costs up front, and was told her bill after insurance was $200.

Six months later, she received another bill for $423. When she called the office, Anderson says she was told it was a facility fee. “I was very frustrated and really kind of angry because they didn’t tell me that up front.”

Devon Herrick, a senior fellow at the National Center for Policy Analysis, says facility fees are becoming more common because more physicians are working for hospitals. “They are being employed by hospitals; hospitals are buying physician practices.”

Herrick says your longtime doctor, oncologist or cardiologist could have been bought by a hospital without you knowing. “Same doctor, same building, nothing looks any different.” He suggests asking your doctor if the office is part of a hospital before treatment.

Officials with Medical City Denton told Consumer Justice the hospital does not charge facility fees. Anderson says after we called, she was given a full refund.

The company that owns First Choice, Adeptus, had no comment for this story. Hernandez says the company offered to cut her facility fee bill in half if she paid immediately, something she cannot afford to do.

A Dallas attorney filed a class-action lawsuit against Adeptus in January, claiming the company uses the public’s confusion over free-standing emergency rooms and urgent cares to prey on patients. Adeptus recently filed for bankruptcy, so the lawsuit is on hold.

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