Outpatient and Provider-Based Department Billing

This type of billing refers to the billing process for services rendered in a hospital outpatient or provider-based department or location. This process takes place when the hospital owns or leases space and employs physicians and other support personnel who are involved in patient care. There are designated specific rules and requirements for outpatient and provider-based department billing, which we follow. Please note that not all of our locations are provider-based.

No. Patients continue to receive quality care with their provider, and scheduling appointments and tests are handled as they always have been. However, Marshall Health processes bills differently. 

Because care is provided in a location that is considered a department of the hospital, your bill will be separated, and you will receive bills for:

1. The professional or physician fee from Marshall Health
2. Hospital/facility resources and services such as procedure, drugs, labs and etc. from Cabell Huntington Hospital, if applicable
3. All other charges related to your visits such as DME suppliers for items such as braces, crutches and etc.

Although this will have little affect on the total combined charge for services, patients are responsible for the co-insurance amount on each bill. These co-insurance amounts are determined by the insurance company and are based on the services performed.
Some patients may be covered by their supplemental insurance and will not have to pay more out-of-pocket costs, but patients without supplemental insurance will have to pay additional out-of-pocket cost related to the provider-based billing structure.

Insurance companies have distinct payment programs for outpatient and provider-based department billing. With the implementation of this type of billing for our physician clinics, Cabell Huntington Hospital is required to follow the billing structure on the other side.