Frequently Asked Questions
What are the “Hospital-Based” locations at Sarah Bush Lincoln
Below is a list of Sarah Bush Lincoln’s Hospital-Based clinics affected by this change in billing.
- Advanced Wound Center (SBL Suite 302)
- Regional Cancer Center (1001 Health Center Drive)
- Urology Clinic (SBL, 1000 Health Center Dr., Suite 305
What does “Hospital-Based” mean?
A Hospital-based clinic is a licensed outpatient facility owned and operated by Sarah Bush Lincoln. Hospital-based status is sanctioned by Medicare for hospitals and clinics. Simply put, it means that physician offices are departments of the hospital and are licensed outpatient facilities owned by Sarah Bush Lincoln. When you see a physician or receive services in a hospital-based clinic, you are being treated within the hospital rather than in a physician’s office. This is the national model of practice for healthcare integrated delivery systems involved in patient care. One of the benefits of having hospital-based status is the opportunity to participate in the Federal 340B Drug Purchasing Program.
What is the 340B Program?
By converting our physician practice locations to hospital-based status, Sarah Bush Lincoln can participate in a program called 340B that extends discounts to hospital providers on some drugs it purchases for use in the hospital outpatient setting. The federally-designed 340B Program enables approved nonprofit healthcare organizations to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. The discounts available through this program will help reduce overall expenses for drug supplies.
Because of the large percentage of Medicaid and Medicare patients it serves, Sarah Bush Lincoln qualified for participation in the 340B program. Not all hospitals qualify for the 340B program.
Will I have to pay an additional fee for my next visit?
There is a facility charge that will be applied to the patient’s insurance plan and be billed accordingly. The patient’s insurance plan coverage will be applied to the charges and the remaining balances will be billed to the patient – one charge for hospital facility fees for the services, facilities, staff and equipment provided by the hospital, and one for professional services. This is similar to how Sarah Bush Lincoln currently bills for other hospital-based services like hospital outpatient surgical procedures.
How will this affect my next visit?
Hospital-based billing will not change your covered services, but it may affect your copayments and deductible. Ask your insurance carrier if your benefit plan covers “clinic services” or “facility charges” in a Hospital-Based Outpatient Clinic and how much of the charge is covered or will be applied to your deductible. You should ask whether your coverage and out-of-pocket responsibility differ for procedures done at hospital-based outpatient clinic as compared to a physician’s office.
What if I’m confused about the bills I get?
If you have questions about your bills, please call the Sarah Bush Lincoln Patient Financial Services at 1-800-381-0040. The team is happy to assist you.
What if I’m having trouble paying my medical bills?
Sarah Bush Lincoln has a number of options for those struggling to pay medical bills, including payment plans and free or discounted healthcare through the Financial Assistance Program. If you’d like to hear more on these options, call Sarah Bush Lincoln Patient Financial Services at 800-381-0040.
Will this billing practice change?
Possibly. Healthcare policies and regulations are constantly changing and evolving. Sarah Bush Lincoln continually monitors its billing practices to ensure it is compliant with the most recent federal guidelines and regulations. If the federal government issues new billing practice guidelines which have an impact on hospital-based billing, Sarah Bush Lincoln will modify its practices accordingly.