Dear patient,
Jennie Stuart Medical Group offices converted to provider-based outpatient departments of Jennie Stuart Medical Center effective December 5, 2022. This clinical integration allows for higher quality and seamlessly coordinated care.
Provider-based outpatient clinics (also known as Hospital-based outpatient clinics) are considered a department of the hospital; “private” provider offices are not (generally, these are smaller physician offices in the community) – like the Jennie Stuart Medical Group offices.
Clinics located miles away from the main hospital campus may still be considered part of the hospital. Provider-based outpatient clinics are subject to stricter government rules, making them more complex and more costly to operate. When you see a provider or receive services in a provider-based outpatient clinic, you are technically being treated within the hospital rather than the private office.
You will notice new signs at these offices designating that they are: “Departments of Jennie Stuart Medical Center”
A provider-based outpatient clinic refers to services provided in hospital outpatient departments that are clinically integrated into a hospital. According to Medicare billing rules, when you see a provider in a provider-based outpatient clinic, the provider and hospital charges are billed separately. For patients with insurance, provider services are processed under physician benefits, which are generally subject to patient liabilities in the form of copayments, while hospital services are processed under hospital benefits subject to deductibles and coinsurance amounts.
Provider-based status is a Medicare status for hospitals and clinics that meet specific Medicare regulations and requires that we bill Medicare (to include some Medicare Advantage plans and Medicaid) in two parts. For patients with certain insurance coverage, your billing statement for each visit or service you receive will show:
Many private insurance companies do not require that we follow the same billing rules required by Medicare. For patients with private insurance, the facility component of the provider office visit will be billed as part of the provider bill and will be processed by the insurance under the patient’s physician benefits.
Co-insurance and deductibles may be covered by a secondary insurance. Check your benefits or with your insurance company for details.
As a participating Medicare Provider, we are required to screen Medicare patients according to the MSP rules. At each visit, you will be asked the MSP questions. These questions help us confirm if Medicare or another payer should process your insurance claim as primary. It only takes a few minutes to complete the questionnaire.
Questions about your provider office bill can be directed to our business office at 270-707-2100.
Consistent with our mission to provide high quality health and wellness services for the community, Jennie Stuart Medical Center is committed to providing affordable care to our patients and as such offers financial assistance programs. Jennie Stuart Medical Center will not pursue extraordinary collections actions against an individual without first using reasonable efforts to determine if such individual is eligible for financial assistance.
Financial Counselors are available Monday through Friday from 7:00am until 3:30pm to discuss the Financial Assistance application process at 270-887-0332 or 270-887-0100 ext. 4505.
A copy of the full Financial Assistance Policy and/or application can be obtained online at https://www.jenniestuarthealth.org/patients-visitors/financial-assistance-guidelines/ or by request.
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