Patient Financial Services
About Provider-Based Billing
Receiving care at MetroHealth’s Provider-Based or Hospital Outpatient billing 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 the patient statement you receive for services provided. Depending on a patient’s specific insurance coverage, it is possible that some patients may pay more for these services and procedures than they would at one of our other sites.
MetroHealth is not unique in this regard as this is the case in many healthcare systems across the country.
Patients are advised to review their insurance benefits or contact their insurance provider directly to determine what their policy will cover and identify any out-of-pocket expenses.
For more information about MetroHealth billing, contact the Customer Service Call Center at 216-957-3250 or toll free 877-509-0597.
Frequently Asked Questions
What does Provider-Based or Hospital Outpatient mean?
Provider-Based or Hospital Outpatient refers to the billing process for services rendered in a hospital outpatient clinic or location. This is the national model of practice for large, integrated delivery systems involved in patient care.
How does this affect billing?
Under this model, patients may potentially receive two (2) statements for services provided within a clinic. One statement represents the facility or hospital charge(s) and one statement represents the professional or physician fee.
Why does MetroHealth do Provider-Based or Hospital Outpatient billing?
Since MetroHealth employs many physicians, following this same type of billing process for outpatient care rendered at our hospitals ensures more appropriate payment for services provided by hospital staff and physicians and distinguishes facilities that function as departments of hospitals from those which are freestanding.
Does this mean patients will pay more for services?
Depending on their particular insurance coverage, it is possible patients may pay more for certain outpatient services and procedures at our provider based/hospital outpatient locations than at one of our other sites. We recommend patients review their insurance benefits or contact their insurance provider to determine what their policy will pay and what out-of-pocket expenses may incur.
What are MetroHealth’s Provider-Based or Hospital Outpatient locations?
Below is a list of MetroHealth locations with provider-based or hospital outpatient billing. Other locations will be included as The MetroHealth System expands services to meet patient needs.
Does this affect patient co-pays or deductibles?
Depending on each patient’s specific insurance benefits, additional patient out-of-pocket expenses may be incurred based on the Provider-Based or Hospital Outpatient model.