Hospital Outpatient Billing
Thank you for choosing MercyOne. Some of our facilities function as a hospital outpatient department of MercyOne Des Moines Medical Center. The FAQs below help answer any questions you may have about hospital outpatient billing practices and how it affects you as a patient.
What does “hospital outpatient” billing mean?
“Hospital outpatient” billing refers to the billing process used for services provided in a hospital outpatient clinic. This is the national model of practice for large, integrated health care systems (such as MercyOne Des Moines Medical Center) where the hospital owns or leases space and employs support personnel involved in patient care.
How does this affect my billing?
Under this model, the care you receive will result in two separate bills. You will receive one bill from MercyOne Des Moines Medical Center for the facility charge as well as a bill from the provider group (such as the Medical Group or Iowa Heart Center) for the professional services or physician charge from the physician who provides your treatment.
Why this billing process?
Inpatients traditionally receive a facility fee and a professional service or physician charge on their hospital bill. Following this same type of billing in the outpatient setting ensures more appropriate payment for services provided by hospital staff and physicians and distinguishes facilities that function as hospital departments but are not located inside of the hospital.
Does this mean patients will pay more for services?
Many insurance plans pay for health care services provided in an outpatient hospital clinic differently than those provided in a doctor’s office. Your insurance plan may require you to meet your annual deductible before it pays for health care services you receive in an outpatient hospital clinic.
Your insurance company may also require you to pay a percentage of the bill, called co-insurance, rather than just an office co-payment. We recommend that you review your insurance benefits or contact your insurance provider to determine your coverage and identify any out-of-pocket expenses you may incur.
In Summary
Receiving care at a hospital outpatient department will result in two separate bills. You will receive one bill from MercyOne containing the facility charge and a separate bill from the provider who provides your treatment containing the professional or physician charge.
Depending on your insurance coverage, your insurance provider may treat these hospital outpatient charges differently than those provided in a doctor’s office. We recommend you review your insurance benefits or contact your insurance provider to determine your coverage and identify any out-of-pocket expenses you may incur.
HOSPITAL OUTPATIENT BILLING LOCATIONS:
