Frequently Asked Questions About Provider Based Billing 

This is a "hospital-based" clinic. This designation affects how you are charged and what you may be required to pay for services at this clinic.

Frequently Asked Questions About Billing at "Hospital-Based Clinics"

Q:     What is a "Hospital-Based" clinic?

A:     A hospital-based clinic is a licensed outpatient facility owned and operated by Saint Louis University Hospital. It is a department of the hospital and therefore subject to stricter government regulation. When you see a physician or receive services in a hospital-based clinic, you are being treated within the hospital rather than in a physician’s office.

Q:      How does this affect my bill?

A:      You will be billed separately for services provided by SLUCare physicians practicing at the clinics and services provided by Saint Louis University Hospital. The Hospital’s bill may include a clinic services fee for the services, facilities, staff and equipment provided by the Hospital, in addition to charges for any procedures done at the clinics.

Q:       Does this mean I will pay more for services at the clinics?

A:      The addition of a clinic services fee means that you may have a higher out-of-pocket cost for your appointment, depending on your insurance coverage. We recommend you review your insurance bene-fits or contact your insurance provider to determine what your policy will pay and what out-of-pocket expenses you may incur.

Q:      What should I ask my insurance carrier?

A:      Ask your insurance carrier if your benefit plan covers "clinic services" or "facility charges" in a hospital-based outpatient clinic and how much of the charge is covered or will be applied to your deductible. You should also ask whether your coverage and out of pocket responsibility differs for procedures done at a hospital-based outpatient clinic as compared to a physician’s office.

Q:      How does this affect a patient who has Medicare?

A:      In a hospital-based clinic, Medicare patients will receive two (2) separate bills for services provided – one for physician services and one for the hospital services. Depending on the services being provided, Medicare patients may incur higher out-of-pocket expenses for a service at a hospital-based clinic than they would at a physician’s office.