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Notice of Beneficiary Co-Insurance
McLaren Health System is implementing hospital-based billing in all employed provider offices. This requires physician practices to operate as outpatient hospital departments versus stand-alone physician offices.
Beginning August 1, 2012, Medicare, some commercial insurance and self-pay patients will receive two bills. One bill is for expenses associated with provider services (physician/PA/NP time), and the other bill is for expenses associated with the office support-related services (nursing, clerical, support services, facility).
What does this mean for Medicare-covered patients?
If you received a service furnished by a department of the hospital, you may incur a coinsurance liability to the hospital. Actual coinsurance liability will be based on the services that you receive and also subject to final determination by the Medicare program.
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Part A Facility
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Part B Professional
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Office Visit-Level 2-99212
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$15.73
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$5.39
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Office Visit – Level 3- 99213
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$15.73
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$10.52
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Office Visit- Level 4- 99214
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$20.88
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$16.14
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If you are enrolled in a second insurance coverage plan or in a state medical assistance program such as Medicaid, your coinsurance liability may be covered in full or your out-of-pocket expense will be lower.
Your coinsurance liability for hospital services is separate from the Medicare coinsurance liability that you may owe for any physician or professional services provided to you.
If you have any questions about your bill or your Medicare explanation of benefits for this service please call (989) 772-6771. McLaren Central Michigan also offers financial assistance.
If you would like more information on which physician offices are hospital-based, call (989) 772-6773. |