Skip to main content

Provider-based billing

What does “provider based” or “hospital based outpatient” mean?

These are terms Medicare uses to describe outpatient clinics that are actually part of a hospital. Basically, Lake Region Healthcare Clinics (our Main Clinic and Walk-In Clinic in Fergus Falls as well as our clinics in Ashby, Barnesville and Battle Lake) are considered to be a part of Lake Region Hospital. It is a very common model of practice for integrated health care systems and is found in many hospitals and facilities within our state and around the nation.

How does provider-based billing benefit our patients?

  • Your medical records will be better coordinated between your physicians.
  • The hospital and physicians will be able to better coordinate your care across clinics and hospital.
  • Our Clinics will be held to even higher clinical standards to maintain the highest patient safety and service quality standards.

How does this change what I will see on my bill?

  • You will see two different charges for your clinic visit. This is a federal regulation. One charge is for services provided by the physician and the other related to the facility-related expenses.
  • You may see two separate Explanation of Benefits from your insurance carrier for the same date of service.
  • Deductibles and co-insurance may apply to one or both charges for the visit, which may result in higher out of pocket costs. If you have a Medicare Supplement, they make cover those balances.

For More Information

If you have questions or concerns about billing please call Patient Financial Services at Lake Region Healthcare at 218.736.8000 or patientfinancial@lrhc.org.