Patients are billed differently at our hospital clinic locations. Patients who have government (Medicare, Medicare Advantage, TRICARE, Medicaid) insurance and self-pay patients, will receive two bills for their visits to a provider-based location — one from Marshall Health for services provided by the physician or other provider and another from Cabell Huntington for facility charges, representing the resources required to support provider services. The amount owed will depend on the actual services provided.
We encourage you to review these frequently asked questions to help you better understand the provider-based, or hospital-based, billing process at some Marshall Health clinic locations:
Frequently Asked Questions
Provider-based billing refers to the billing process for services rendered in a hospital outpatient 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 provider-based 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 test 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:
- The professional or physician fee from Marshall Health
- Hospital/facility resources and services such as procedure, drugs, labs and etc. from Cabell Huntington Hospital, if applicable
- 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 charges for services, patients are responsible for the co-insurance amount on each bill. These co-insurances amounts are determined by the payer 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.
Payers have distinct payment programs for provider-based-billing. With the implementation of provider-based billing for our physician clinics, Cabell Huntington Hospital is required to follow the above-described billing structure.
For questions about your bill or to request an itemized statement, call: