Effective September 15th, 2019, many physician offices will convert to provider-based clinics and operate as departments of Conway Medical Center. This new arrangement enables us to best manage our resources in a strategic way for our patients and the future of healthcare in our communities.
What is Provider-Based Billing?
Provider-Based Billing refers to the billing process for services rendered in a hospital department or location. This process takes place when the hospital owns space and employs physicians and other support personnel who are involved in patient care. The physician practice is now a department of the hospital.
This benefits patients as all departments of the hospital are subject to rigorous quality standards and are surveyed by DNV-GL Healthcare, an accrediting organization for hospitals, which surveys hospitals annually. DNV creates accountability to proven hospital health care safety and quality standards, such as fire safety, patient safety, infection prevention, and quality improvement while promoting close collaboration between physicians and team members. DNV also provides public acknowledgment of facilities meeting their high safety and quality standards.
Will there be a change in how patients receive care?
No. Patients will continue to receive excellent quality care with their physician and scheduling appointments and tests will be handled as they always have. However, there is a change in how CMC will bill your insurance carrier for these services.
How does this affect the billing process?
Because care is provided in a department of the hospital, patients will receive a bill from Conway Medical Center as well as a separate bill for the professional services provided by their physician. This also includes physicians who interpret the results of diagnostic tests.
Medicare beneficiaries are responsible for the co-insurance amount on the services you receive. These amounts are determined by Medicare and are based on services performed.
Will Medicare patients have to pay more for services?
Some Medicare patients may be covered by their supplemental insurance and will not have to pay more out-of-pocket. Medicare patients without supplemental insurance may have to pay a small amount. Patients with other health insurance should check with their insurance provider and ask whether it covers facility charges or Provider-Based Billing.