Like many medical centers and community hospitals across the nation, Skagit Regional Clinics, which is now a department of Skagit Valley Hospital, converted several of its physician clinics to hospital-based outpatient clinics on July 14, 2011.
If you would like to receive information about price comparisons between our hospital-based and freestanding clinics, call 360-428-2521.
Hospital-Based Billing Frequently Asked Questions (FAQ)
What does “hospital-based” outpatient mean?
The Centers for Medicare and Medicaid Services (CMS) have designated Skagit Regional Clinics as a “hospital-based” outpatient department of Skagit Valley Hospital. “Hospital-based” outpatient refers to the billing process for services rendered in a hospital outpatient clinic or location. This is the national model of practice for integrated health care systems like Skagit Regional Health, where the hospital (Skagit Valley Hospital) owns space and employs support personnel involved in patient care in outpatient clinics (Skagit Regional Clinics).
How does “hospital-based” outpatient billing affect patients?
Medicare and Medicaid patients receiving outpatient services (i.e. office visits, procedures, treatments, etc.) at one of Skagit Regional Clinics’ hospital-based outpatient clinics will notice a change in the way they are billed. Under “hospital-based” status, Medicare requires SRC to bill all hospital-based services in two parts. Therefore, patients will see two charges on their bill. One charge represents the facility charge (Part A) and the other represents the professional or physician fee (Part B) for outpatient services or procedures. Previously, all charges were grouped together on the billing statement.
Patients admitted to the hospital have historically received two bills. Following this same type of billing for services rendered at hospital-based outpatient locations ensures more apporpirate payment for services provded by hospital staff and physicians, and distinguishes facilities that function as departments of a hospital.
Patients are advised to review their insurance benefits to identify any out-of-pocket expenses they may incur.
What are the benefits of being cared for at a “hospital-based” outpatient clinic?
Medicare acknowledges the value of providing care in an integrated, collaborative environment. Hospital-based outpatient clinics are held to nationally recognized service and patient care standards, leading to high quality care for patients.
Medicare patients will be charged a facility fee that would not be owed if the facility were not hospital-based. Patients may have to pay more for certain outpatient services and procedures at SRC’s hospital-based outpatient locations than they would at one of SRC’s free-standing clinic locations.
- Cascade Skagit Health Alliance
No. SRC’s Anacortes, Camano Island and Urology locations will remain as freestanding clinic locations. They will not be converted to hospital-based outpatient clinics at this time, so an additional facility charge will not be generated at these locations.