For years, a growing number of healthcare providers have been tacking on fees that most patients didn’t notice because they were being paid by insurance companies. But as insurance companies trim the list of fees they’ll cover — and employers shift to cheaper health plans to keep costs from skyrocketing, consumers are being hit with fees they weren’t expecting.

CBS Sacramento’s Kurtis Ming has the story of a local man who after five years without having to see a particular doctor about his elbow issues, made an appointment with the hospital at the University of California Davis.

It wasn’t until he arrived that he was told his former doctor was no longer associated with the hospital. And it wasn’t until he saw his bill later that he discovered a $164 “new patient” fee.

“They said they automatically charge it to anyone who hasn’t been to the facility in three years,” the patient tells Ming.

When asked about the fee, a rep for the UC Davis Medical Center responded:

Our new patient charge is a fair reflection of the additional time and resources required to get completely up-to-date on a patient who hasn’t been seen in more than three years… The charge is common nationwide because it reflects a clinical reality, which is why health insurance typically covers much of this cost as part of a payer’s negotiated contract with providers.

However, this patient’s insurance now doesn’t cover this sort of fee. Thus, it fell on his shoulders to pay something he’d never even known he would be charged.

This man could have sued if a garage mechanic added a fee without disclosing in advance, but when it comes to doctors it’s apparently fair game.

A consumer advocate with United Policyholders tells Ming that while the fee doesn’t seem very fair, it’s just one of an increasing menu of charges that healthcare providers are dinging customers for.

Talking on the phone with your doc? That’s a fee. Need a prescription called in? That’s a fee. According to this report from CBS Minnesota, some doctors are adding a “split visit charge” when patients ask the doctor about something other than the main reason for the visit.

So if you’re going to see the doctor because your eyeball is falling out, be aware that you might be charged extra for asking about that star-shaped rash on your right buttock.

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