Provider Based Billing FAQ's
Provider Based Billing FAQ's
For patients of the following outpatient departments of Centra Lynchburg General Hospital:
• Lynchburg Hematology Oncology
• Lynchburg Radiation Oncology
• The Stroobants Cardiovascular Group, Atherholt Road
• Seven Hills Urology, Langhorne Road and Oak Vassar locations
Q: What does "provider-based" mean?
A: "Provider-based" or "hospital-based" is a designation status established by Medicare and Medicaid that refers to the billing process for services rendered in a hospital outpatient location. The provider-based designation applies to patients seen at provider based locations only. As an outpatient department of Centra Lynchburg General Hospital, Lynchburg Hematology Oncology, The Cardiovascular Group and Seven Hills Urology and its affiliated physicians share a commitment to providing high quality, well-coordinated patient-centered care. This will be measured by our achieving The Joint Commission accreditation status as an outpatient department of Centra Lynchburg General Hospital.
Q: What are Centra's provider-based locations?
A: There are three locations – Lynchburg Hematology Oncology at The Pearson Cancer Center, The Stroobants Cardiovascular Group located on Atherholt Road and Seven Hills Urology on Langhorne Road.
Q: How will my bills be affected by provider-based billing?
A: Patients who are covered by supplemental or secondary insurance may not have any additional out-of-pocket expenses for care. However, patients who do not have secondary or supplemental insurance will have additional out-of-pocket expenses to meet their annual deductible and co-pay. That's why we're asking patients with health insurance to check with their insurance providers to determine what will be covered. Depending on specific insurance, some patients may pay more out of pocket for these services and procedures than they would at one of our other facilities.
Q: Can you provide more details on how the billing process will change?
A: Patients will receive two separate bills for services provided at Lynchburg Hematology Oncology at The Pearson Cancer Center, The Cardiovascular Group on Atherholt Road and Seven Hills Urology on Langhorne Road:
One bill will be for professional services delivered by the physicians and other providers,
And a second bill will be for facility costs associated with the visit.
As a result of the two bills, some patients will receive two Medicare Summary Notices from Medicare or insurance explanation of benefits. Once insurance processes their portion of the claims, the balance will be submitted to a secondary insurance, if one is provided. Patients who have a balance after the secondary insurance or who do not have supplemental insurance will receive two bills for the remaining balance:
One bill from the Centra Medical Group and
One bill from Centra Lynchburg General Hospital.
Q: Will Centra help me with my insurance company or offer any assistance with out-of-pocket expenses?
A: Centra offers a variety of payment options and assistance programs for qualified patients having financial difficulty. A Centra Customer Service Representative is available for assistance at 434.200.3777.
Q: Who should I contact if I have more questions?
A: For hospital billing, contact a Centra Customer Service Representative at 434.200.3777. For professional billing, contact the Centra Medical Group at 434.200.3656.