Understanding Your Medical Bill Charges

Had a recent visit or procedure at one of our physician offices or family health centers? You may have noticed two types of charges on your bill: hospital services and clinical professionals.

• Hospital Services: Covers your room and any medical or technical services, supplies or equipment. The facility and/or treatment room charge will be shown here.
• Physician and Clinical Professionals: Covers your doctor’s services, treatment, or procedures. This also applies to other clinical professionals involved in your care.

Frequently Asked Questions About Provider-Based Billing

What does provider-based mean?

Provider-based is a Medicare classification. It means that hospitals have met specific Medicare regulations to have their outpatient doctors’ offices and clinics classified as provider-based facilities.

When we provide care in a provider-based setting, you’ll see two charges: the charge for the care and for the facility.

For example, if you go to one of our family health centers for a doctor’s visit and chest X-ray, you will see the charges for the care and for the facility.

I have health insurance with my employer. How does provider-based billing affect me?

This billing applies to all patients, regardless of the type of insurance you have.

The way your insurance company covers the hospital service part of your bill varies. It’s based on whether you have insurance through your employer, another insurance company, or if you’re covered by Medicare. Some insurance companies cover this part of your bill, while others apply it to your deductible.

Contact your insurance company to understand your benefit design. If you have questions, call one of our financial counselors.