Provider-Based Billing (PBB)
Provider-based billing is billing for care provided in a hospital outpatient clinic or location, indicated as a “department of the hospital.” Provider-based billing means there may be charges for both the hospital and the physician portions of care.
PBB Information Line: 833-484-8539
PBB Frequently Asked Questions:
How does this affect billing?
If you receive care at a hospital outpatient department, you may receive a statement with two charges for services provided within that department: one for the facility or hospital charge and one for the professional or physician fee.
How will this impact my bill?
Depending on your insurance, you may have a higher out-of-pocket responsibility for certain outpatient services and procedures at our provider-based/hospital outpatient locations. We recommend that you review your insurance coverage or contact your insurance provider to determine what your policy covers and what out-of-pocket expenses you may incur.
What should I ask my insurance carrier?
You can ask whether your insurance plan covers facility charges in an outpatient hospital clinic. If it does, you can ask what percentage of the charges are covered. You will also want to verify what your hospital outpatient benefits are, as they are most often applied toward your deductible and coinsurance.
Why does Guthrie use provider-based billing?
Provider-based billing ensures clinics meet the comprehensive quality standards required of hospitals and promotes the highest levels of coordination of care. Provider-based billing is the national model for health care systems, adopted by many regional and national organizations.
What if I need help paying my bill?
If you worry that you may not be able to pay for part or all of your care, we may be able to help. Visit our financial assistance page for more information.
What are Guthrie’s provider-based locations?
Click here for a list of Guthrie’s provider-based locations.