Understand My Bill
Hospital-Based Services and Provider-Based Billing
Each of Spectrum Health’s hospitals offer both inpatient and outpatient services, including physician clinics and outpatient departments that are not located on the main hospital campus. Although these locations are not physically attached to the hospital, they are still considered part of the hospital and are subject to the same quality, regulatory and accreditation standards as the hospital. You will know a location is part of the hospital if it is operated under the name of the hospital.
Hospital-based locations are subject to the same quality, regulatory and accreditation standards as the hospital. This allows for improved coordination of care, operational efficiencies, and collaboration across physician specialties.
As a part of the hospital, these clinics are subject to “provider-based billing” requirements. Provider-based billing means there are two separate bills to your insurance company. The hospital bills for its “facility charges,” which cover any tests, procedures, supplies, and clinical and non-clinical staff. The physician, physician assistant, or nurse practitioner will separately bill for their professional services or “professional charges.”
Since all insurances have different benefits and out of pocket expenses, we encourage you to contact your insurance company prior to your appointment to discuss this.