EvergreenHealth bills a facility fee for visits to its clinics that are considered hospital-based. This additional bill, or facility fee, is a charge to cover a portion of the expenses of hospital-based departments where enhanced specialty services are necessary.
The hospital-based departments at EvergreenHealth are licensed outpatient facilities of the hospital campus. An outpatient department is a hospital department where services are provided or procedures are performed, but where the patient’s visit is of a shorter duration than an overnight hospital stay.
The facility fee related to your hospital-based service may result in a higher out-of-pocket expense than if you received similar services in a private physician office. This is because you may have a co-pay, or a deductible amount responsibility, for each of the bills. It is important to check with your insurance company to find out the patient responsibility percentage for a facility fee in a hospital-based department.
Some insurance plans have different payment rates and policy benefits for facility vs. clinic charges.
EvergreenHealth does hospital-based, or provider-based, billing because there are certain services that require a higher level of care coordination. For these areas, EvergreenHealth provides care in a clinically integrated setting, with access to all the extra services mentioned prior. Whether or not the physician providing services is employed by EvergreenHealth isn’t the determining factor for hospital-based or provider-based billing. It is dependent on the type of service provided and whether it requires the extra level of care coordination.
Depending on a person’s particular insurance cover-age, it is possible patients may pay more for certain outpatient services and procedures at EvergreenHealth’s hospital-based department locations than at one of our other sites. For this reason, we recommend patients review their insurance benefits or contact their insurance provider to determine what their policy will pay and what out-of-pocket expenses they may incur.
It can, depending on a patient’s specific insurance benefits. Additional patient out-of-pocket expenses may be incurred through the hospital- or provider-based model, because of the possibility of a co-pay or deductible responsibility for each of the bills.
As a nonprofit health-care provider, it is EvergreenHealth’s mission to improve the health and well-being of each person it serves, regardless of their ability to pay. To do this, EvergreenHealth offers discounting and charity-care policies to help qualifying patients.
For questions regarding a facility charge on your billing statement, possible financial assistance or payment plan options, call 425.899.1600.
Receiving care at EvergreenHealth’s hospital-based department locations may result in a facility fee as well as a professional or physician charge for outpatient services and/or procedures. These charges will be reflected on the patient statement you receive for services provided. Depending on a patient’s specific insurance coverage, it is possible that some patients may pay more for these services and procedures than they would at one of our other sites. EvergreenHealth is not unique in this regard as this is the case in many integrated health-care delivery systems across the country.