Financial Resource Center Provider-Based Billing Provider-based, or hospital-based, billing CoxHealth has provider-based clinics that operate as an extension of the main hospital—meaning the main campus owns the clinic space and employs staff who assist with patient care. These locations are also referred to as hospital-based and are outpatient departments of the hospital. Like our hospital locations, these clinics are equipped with the resources and expertise of the hospital, enabling integrated care close to home. Our billing practices reflect our commitment to extending our hospital's resources to the community.What to expect from a provider-based locationProvider-based CoxHealth clinics are subject to specific billing requirements—meaning we'll send the following two claims to your insurance company:Facility costs for services provided by the hospital, or hospital-based facility, including:Staff, such as nurses and receptionistsDiagnostic services, such as laboratory and X-raySupplies and medicinesPhysician costs for services provided by the doctor, including:ExamsOrdering and reading of testsProcedures performedRead the frequently asked questions below to learn more. Frequently Asked Questions FAQs What is provider-based billing? What CoxHealth locations are billed as provider-based locations? Will my insurance cover provider-based services and will I pay more? Why does CoxHealth participate in provider-based billing? What can I do if I am having difficulty paying my bill? What is provider-based billing? Provider-based billing is a type of billing for services provided in a clinic or department considered part of the hospital. This often is the case with large health care systems. Clinics located several miles away from the main hospital campus may be considered part of the hospital. Even though you're seeing your regular physician in a clinic setting and not actually hospitalized, you will receive two statements for the visit. One statement will be for the professional charges provided by the doctor—also known as a "professional fee." The other statement will be for the facility charge. Previously, all services were provided by the physician clinic and charges were grouped together in one statement. What CoxHealth locations are billed as provider-based locations? CoxHealth Advanced Medicine SpecialistsCoxHealth Heart Center BransonCoxHealth Pain and NeurologyCoxHealth Wound Care and Hyperbaric MedicineCoxHealth - CardiologyCoxHealth - CardioThoracic SurgeryCoxHealth - ElectrophysiologyCoxHealth - GastroenterologyCoxHealth Infectious Diseases Specialty ClinicCoxHealth Medical OncologyCoxHealth - NeurologyJared Neuroscience CenterCoxHealth - PulmonologyRegional Perinatal CenterCoxHealth - RheumatologyCoxHealth - Internal MedicineCoxHealth - Vascular Medicine/SurgeryCox Hyperbaric Medicine and Wound CareCoxHealth - Radiation OncologyPediatric Urgent Care Plus Springfield: Turner Center24/7 Urgent Care Plus Springfield: Turner Center Will my insurance cover provider-based services and will I pay more? Depending on your insurance coverage, some benefits may differ for services and procedures provided in these locations. For example, under some insurance plans, services may be applied to your outpatient deductible rather than be included in your standard co-pay. Further, Medicare beneficiaries are responsible for the co-insurance amount on the services they receive. These amounts are determined by Medicare and are based on services performed.We recommend you review your insurance benefits or contact your insurance provider to determine what your policy will pay and what out-of-pocket expenses you may incur based on the services' location. Ask your insurance company if your benefit plan covers charges in provider-based outpatient clinics and how much is covered, will be applied to your deductible, or is subject to insurance. Why does CoxHealth participate in provider-based billing? This is the national model of practice for large health care networks where the hospital owns space and employs support staff who assist with patient care. It has been adopted by many medical centers locally and nationally. It benefits patients because all hospital departments are subject to strict quality standards and are monitored and accredited by DNV. What can I do if I am having difficulty paying my bill? Request an appointment for free, local help from a CoxHealth financial navigator, or call 417-269-3117 for assistance.