Preoperative Shower-Instructions
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What is “Provider-based” or “Hospital Outpatient Department” Status?
Provider-based status is a Medicare designation for imaging centers, outpatient rehabilitation centers, medical clinics and other services that are provided through departments of Arise Austin Medical Center. The provider-based structure is a national practice for integrated healthcare systems like Arise Austin Medical Center. Simply put, it means these imaging centers, outpatient rehabilitation centers, medical clinics and other ancillary medical services are considered to be departments of the hospital (clinically, financially, and administratively).
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How Will My Billing Change?
Patients visiting a provider-based entity will receive a bill from the hospital for facility-related technical fees and a separate bill from the physician provider for any professional services rendered. This methodology is no different than the way most hospitals currently bill for other on-campus hospital services like the Emergency Department, Therapy Services, Lab Services and Surgical Procedures. An example of this would be when you visit the Hays or Riverplace Imaging Center for an imaging study like an MRI, you will:
- Receive a bill from the Radiologist reflecting the professional component of interpretation of your MRI.
- Receive a bill from Arise Austin Medical Center which covers the cost of the technical staff, MRI and associated equipment, medical records administration, technology used to distribute the images back to your referring physician, and supplies used while in the outpatient department facility.
Your total out-of-pocket expense for a visit could be more, could be the same or could be less depending on the type of visit and your insurance plan. Depending on one’s insurance, this may mean that you will have an additional co-pay and/or deductible (one for the hospital and one for the provider). Medicare patients carrying supplemental insurance will not see a change in their out-of-pocket expenses.
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Is This Billing Process New for Arise?
No, this is a simple expansion of the billing already in use for our on-campus hospital services. For on-campus services like Emergency Department, Rehabilitation Services, Laboratory, and Surgical Procedures, AAMC has always billed separately for Facility (Technical) and Physician (Professional) services fees—a bill from the hospital and a separate bill from the provider clinic. As we continue to expand our off-campus hospital services into Central Texas communities, this billing method will be utilized in those imaging centers, outpatient rehabilitation centers, medical clinics and other ancillary medical services.
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How Will This Affect My Visit?
Provider Based billing will not change your covered services, but it may possibly affect your co-payments.
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What if I Have a Question About the Bills I Get in the Mail?
If you have any questions about your bills, call one of our medical billing specialists and we will be happy to assist you. Or call the number on the back of your insurance card for clarification of how this might impact your payments.
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Forms for your visit: