Hospital-based outpatient billing (provider-based billing)
Receiving care at Poudre Valley Health System's provider-based or hospital-based outpatient billing locations results in a hospital facility charge and a professional/doctor's charge for outpatient services (or procedures).
Provider-based billing is a widely used approach to billing (with requirements set by the Centers for Medicare
and Medicaid Services) for integrated health care services like those at Poudre Valley Health System.
What does it mean to be a "hospital outpatient department?"
Hospital outpatient department services are those given in a hospital clinic or other hospital-run location.
According to federal guidelines, receiving outpatient services in a hospital-based outpatient department is the same as receiving care in the hospital.
Patients benefit because hospitals are subject to strict quality standards monitored by The Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 17,000 health care organizations and programs in the United States.
How does a hospital outpatient department affect my bills?
Under the hospital outpatient department system, you receive two (2) bills. The first bill reflects facility fees
from Poudre Valley Hospital or Medical Center of the Rockies for technical staff, equipment and supplies involved in your care. The second bill reflects fees from Poudre Valley Medical Group for your doctor's professional fees.
How is provider-based billing different from my previous bills?
You will receive two separate bills for services when previously you may have received them in one bill.
Does this mean I now pay more for services?
Depending on your insurance coverage, it is possible that your benefits may differ and additional or
higher co-pays will be required. Patients are advised to review their insurance benefits or contact their insurance provider to learn their policy terms and identify out-of-pocket expenses.
Does this affect my co-pays or deductibles?
Depending on your insurance coverage, possibly. Please know we are here to help. As a healthcare
system, we have more support tools and available resources to provide you to help with possible cost changes. You may contact our Patient Financial Services team to learn more about your individual situation at 970.237.7200.
What if I have more questions or concerns?
We understand these changes can be confusing and want to assist with any concerns you have. To help you know if you will have any cost changes, we have a financial counseling team ready to help. These team members can work with you to help you learn your insurance policy's terms and out-of-pocket expense you may incur. Please call 970.237.7200.
What if I have difficulty paying my bills?
Please contact our Patient Financial Services at 970.237.7200 to learn more about possible options.