Effective September 1, 2025, Permian Cardiology will become a hospital outpatient department of Midland Memorial Hospital. This change is designed to more fully integrate the care a patient receives across the Midland Health system of partners. Departments are clinically integrated with the hospital and will be subject to the DNV Patient Safety and Service quality guidelines.
The Center for Medicare and Medicaid Services (CMS) permits physician office clinics to operate as “provider-based” when certain conditions are met. These physician office clinics are integrated into the hospital and are therefore permitted to bill services as a hospital outpatient department to government operated insurance plans. These charges often show up on a statement as “facility charges” which help cover the additional expenses of operating an outpatient department of a hospital compared to a free-standing physician office.
Provider-based billing has become a common model of practice for health systems locally and around the U.S. Patients benefit because all participating hospital facilities must follow stricter quality standards and offer additional resources for patients and their families.
No. You will continue to receive excellent quality care from the same doctors you have come to know and trust. Scheduling for appointments and tests will not change.
CMS has separate payment programs for provider-based billing. Provider-based billing only applies to patients with Medicare, Medicaid or select Medicaid Managed Care programs. The billing statement for each visit or service you receive will show:
o One charge for the professional services from the provider you see.
o One charge for the facility, which covers the use of the room and any medical or technical supplies, equipment and support staff.
Laboratory and radiology services are provided by the hospital and are billed by the hospital regardless of the type of insurance. Hospital services are generally processed under the benefit plan’s hospital benefits and are subject to deductibles and coinsurance amounts.
Depending on a patient’s particular insurance coverage, it is possible that some patients may pay more for certain outpatient services and procedures at provider-based clinic departments. Medicare patients will incur a coinsurance cost to the hospital that you would not incur if the facility was not a provider-based clinic. Patients who have a Medicare supplemental payer typically do not get billed for any out-of-pocket expenses for Medicare covered visits at a provider-based billing department. This is never guaranteed and is subject to each patient’s specific policy and benefits. We recommend you review your insurance benefits or contact your insurance provider to determine what the policy will pay and what out-of-pocket expenses may be incurred.
As a participating Medicare provider, we are required to screen Medicare patients according to the MSP rules. At each visit, you will be asked MSP questions. These questions help us confirm if Medicare or another payer should process your insurance claim as primary
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