Concern over new hospital fees added to patients' bills for outpatient clinic visits at the Guam Memorial Hospital prompted a public hearing recently. Two local insurance providers argues it would worsen the financial burden of healthcare for both patients and payers.

The Guam Memorial Hospital’s new facility fees for outpatient clinic visits under scrutiny from senators during a recent public hearing. Calvo’s SelectCare and Staywell Insurance testified against the new fees during GMH’s public hearing back in December when the hospital proposed a total of 99 new fees. They argue it goes against industry standards and that a costly professional fee is already being charged for the same visit.

Senator Therese Terlaje read a portion of their written testimony, announcing, "According to SelectCare, the hospital has to select one of the two fees. He notes many of the professional fees are significantly higher than those charged by other contracted hospitals in the area, as well as the fees reimbursed in hospitals in Hawaii and California."

"This is not a standard practice in Guam and StayWell does not reimburse this code separately. This code reflects a 54% cost escalation in comparison to MCS Medicare reimbursement."

The new facility fees tacks on $125.95 to a patient's bill for outpatient clinic visits in the hospital across various specialties, including cardiology, interventional radiology, podiatry, pulmonary, and special services.

GMH chief financial officer Yuka Hechanova says other hospitals have established the same fee. She detailed, "So we normally charge the professional fee but we’ve never charged facility fee and the staff had researched this was something that we could charge because we have the clinics onsite in the hospital."

GMH's board of trustees approved the new fees in March despite the concerns, of which Senator Terlaje said, "What happens when they don’t pay like they’ve threatened?" with Hechanova replying, "There is an appeal process that we go through and that's what we’ve instituted. First, we handle it informally where we discuss why they won’t pay it. Then it does eventually get escalated to legal."

Further questioning from Terlaje revealed that the hospital is already trying to appeal denied claims. GMH legal counsel Jordan Paulun says total outstanding pending claims are at about $400,000.