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Provider-based billing

Lake Region Healthcare physician offices and outpatient clinics are considered hospital outpatient departments (also called "provider based") by Medicare. This means you will see a facility charge on a hospital billing statement. A facility charge covers the use of the room and any medical or technical supplies or equipment. This facility charge may incur a coinsurance liability for which you will be responsible; your actual liability that you will owe will depend upon the actual services provided. Your clinic billing statement will include charges for doctors' services, treatment or procedures. Provider based is a Medicare Classification. It means that hospitals have met specific Medicare regulations to have their outpatient doctors' offices and clinics classified as provider based. Hospital systems classified as provider based by Medicare results in uniform billing.

In summary, receiving care at Lake Region Healthcare provider-based locations may result in a facility charge as well as a professional or physician charge for outpatient services and/or procedures. These charges will be reflected on patient statements you receive for services provided. Depending on a patient's specific coverage it is possible that some patients may pay more for these services and procedures than they would at other sites that is not unique in this regard, as this is the case in many healthcare delivery systems across Minnesota and the country.

If you have any additional questions regarding provider-based billing or your statement, please contact our business office.