Provider-Based Billing Notice

ClearPath Surgical Clinic at The Spine Hospital of Louisiana is a provider-based outpatient department of The Spine Hospital of Louisiana. This means that the clinic is owned, operated, and billed as part of the hospital.

 

You are receiving services in a provider-based facility when you receive care at:

ClearPath Surgical Clinic at The Spine Hospital of Louisiana

 

What Does Provider-Based Mean?

Provider-based is a billing structure defined by federal regulations when a hospital owns and operates a clinic as an outpatient department of the hospital.

 

Because ClearPath Surgical Clinic at The Spine Hospital of Louisiana is provider-based:

  • The hospital bills for the facility services, and
  • The physician bills separately for professional services

Both charges are part of the same visit but appear as separate line items on your insurance claim or patient statement.

 

Billing Information

If you are covered by Medicare or certain other insurance plans, your visit may include:

  • A hospital outpatient facility charge billed by The Spine Hospital of Louisiana, and
  • A professional charge billed by the ClearPath Surgical Clinic physician for services provided.

 

You may also receive charges for additional services ordered by your provider, such as imaging or other diagnostic services.

 

Medicare and other insurance plans generally cover both the facility and professional charges, subject to any deductible, coinsurance, or copayment amounts for which you are responsible.

 

Coinsurance

Coinsurance is the portion of covered charges that you are responsible for paying after your deductible is met.

 

For example, under Medicare Part B, patients are typically responsible for 20% of the Medicare-allowed amount for covered outpatient services.

 

When services are provided in a provider-based clinic, coinsurance may apply to:

  • The hospital facility charge, and
  • The physician professional charge

 

Deductibles

A deductible is the amount you must pay before your insurance begins to pay for covered services.  Receiving care at a provider-based clinic does not increase your annual deductible, but your insurance plan may apply your deductible separately to:

  • The hospital facility charge, and
  • The physician professional charge

 

If you have secondary insurance, it may cover some or all the deductible and coinsurance amounts. Any remaining unpaid balance will be billed to you.

 

Questions About Your Bill?

ClearPath Surgical Clinic at The Spine Hospital of Louisiana

Billing Department: 225-763-9900, Option 7, then Option 6
10101 Park Rowe Ave, Ste 201, Baton Rouge, LA 70810