Hospital-Based Billing

Hospital-based billing and the information contained on this page pertain to Medicare patients only.

Thank you for being a valued patient at one of Valley Medical Center’s hospital-based locations. Several of Valley Medical Center’s clinic locations now function as part of the Hospital as a hospital outpatient facility. (See list of clinic locations below).

What is Hospital-Based Billing (HBB)?

Hospital Based Billing (HBB) refers to the billing process for services rendered in a hospital outpatient clinic or department.  This is the national model of practice for integrated delivery systems where the hospital owns space and employees support personnel involved in patient care.

This benefits patients as all departments of the hospital are subject to strict quality standards and are monitored by the Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 17,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

Will there be a change in how patients receive care?

No. Patients will continue to receive excellent quality care with their physician and scheduling appointments and tests will be handled as they always have been in the past. However, there is a change in how Valley Medical Center will bill your insurance carrier for these services.

How does this affect the billing process?

Because care is provided in a department of the hospital, patients will see two charges on your Valley Medical Center combined statement.  One charge will be for the professional services provided by your physician.  This is also called the professional fee.  One charge will be for the facility charge.  Previously, all services were provided by the physician’s office and charges were grouped together for your clinic visit.

Medicare beneficiaries are responsible for the co-insurance amount on the services you receive. These amounts are determined by Medicare and are based on the services performed.

Will Medicare patients have to pay more for services?

Some Medicare patients may be covered by their supplemental insurance and will not have to pay more out-of-pocket.  Depending on their particular insurance coverage, it is possible benefits may differ for certain outpatient services and procedures at a provider-based, hospital outpatient location.   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 based on the location of the services provided.

Where can patients call for more information?

If you have any questions regarding Hospital-Based Billing, please feel free to contact us at 425.656.5412.

List of Hospital-Based Clinics:

 

Cascade Clinic

4033 Talbot Rd S, Ste 570

Renton, WA 98055

425.656.5400

 

Covington Clinic North | Primary Care

16850 SE 272nd St

Covington, WA 98042

253.395.1960

 

Covington Clinic North | Urgent Care

16850 SE 272nd St

Covington, WA 98042

253.395.2006

 

Kent Clinic

24920 - 104th Ave SE

Kent, WA 98030

253.395.2000

 

Valley Family Medicine Clinic

3915 Talbot Rd S, Ste 401

Renton, WA 98055

425.656.4224

 

North Benson Clinic

10555 SE Carr Rd. Building M

Renton, WA 98055

425.656.4270

 

Nephrology Clinic

24920 104th Ave SE

Kent, WA 98030

253.395.1944

 

Diabetes Education & Nutrition Clinic

24920 104th Ave SE

Kent, WA 98030

425.656.5377

 

Rheumatology Clinic

16850 SE 272nd St, Suite 200

Covington, WA 98042

253.395.1971

 

Podiatry Clinic

24920 - 104th Ave SE

Kent, WA 98030

425.203.7290