Hospital-Based Outpatient Billing

Receiving care at Penn State Medical Group “Hospital-Based Outpatient” locations may result in a hospital charge as well as a physician charge for outpatient services and/or procedures. These charges will be reflected on your patient statement.

Questions about coverage

800-254-2619

Questions and Answers

Penn State Medical Group provider practices are owned and operated by Penn State Health Milton S. Hershey Medical Center. These Medical Group practices are designated as “Hospital-Based Outpatient” practices under federal guidelines. It is a national model of practice for integrated healthcare delivery systems like Penn State Health, in which the hospital owns the practice and employs the staff involved in patient care.

Receiving care at Penn State Medical Group “Hospital-Based Outpatient” locations may result in a hospital charge as well as a physician charge for outpatient services and/or procedures. These charges will be reflected on your patient statement.

Depending on specific insurance coverage, it is possible that some patients may pay more than they would at one of our other locations.

Please review your insurance benefits or contact your insurance provider to determine what your policy will cover and identify any out-of-pocket expenses.

For Medicare Patients: you will incur a coinsurance liability to the hospital that you would not incur if the facility were not hospital-based.

For more information, please contact our Patient Financial Services offices at 800-254-2619 if you have further questions regarding “Hospital-Based Outpatient” billing.

FAQs

Q: What does “Hospital-Based Outpatient” mean?

A: “Hospital-Based Outpatient” refers to the billing process for services rendered in a hospital outpatient clinic or location. This is a national model of practice for large integrated health care delivery systems like Penn State Health where the hospital owns the practice and employs the support personnel involved in patient care.

Q: How does this affect patient billing?

A: Under the “Hospital-Based Outpatient” model, patients may receive two charges on their patient bill. One charge represents the facility fee and one charge represents the physician fee. Previously, all charges were grouped together on your billing statement.

Q: Why use this billing process?

A: Patients admitted to the hospital or seen in our outpatient practices based on the Medical Center’s campus have historically received two (2) charges on their bill. Following this same type of billing process ensures more appropriate payment for services provided by hospital staff and physicians.

Q: Does this mean that patients will pay more for services?

A: It’s possible some patients will pay more for certain outpatient services and procedures at our hospital outpatient locations, depending on their specific insurance coverage. Medicare patients will incur a coinsurance liability to the hospital that they would not incur if the facility were not hospital-based.

We encourage patients to 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. Please note that some clinical labs which have been drawn may be sent to the Medical Center for processing and show a Hospital Outpatient Lab Charge.

Q: What are Penn State Health‘s “Hospital-Based” outpatient locations?

A: The following Penn State Health locations are all designated as “Hospital-Based”:

  • Penn State Children’s Hospital - Lancaster Outpatient
  • Penn State Medical Group - Briarcrest – Adolescent Medicine
  • Penn State Medical Group - Briarcrest – Diabetes and Weight Management
  • Penn State Medical Group - Briarcrest – Pediatric Specialties
  • Penn State Medical Group - Camp Hill – Radiology
  • Penn State Medical Group - Camp Hill – Family Medicine
  • Penn State Medical Group - Camp Hill – Lab
  • Penn State Medical Group - Camp Hill – Specialties
  • Penn State Medical Group - Elizabethtown
  • Penn State Medical Group - Fishburn Road
  • Penn State Medical Group - Harrisburg
  • Penn State Medical Group - Mechanicsburg
  • Penn State Medical Group - Middletown
  • Penn State Medical Group - Mount Joy
  • Penn State Medical Group - Nyes Road – Children’s Heart Group
  • Penn State Medical Group - Nyes Road – Family Medicine I
  • Penn State Medical Group - Nyes Road – Family Medicine II
  • Penn State Medical Group - Nyes Road – HVI
  • Penn State Medical Group - Nyes Road – Lab
  • Penn State Medical Group - Nyes Road – Radiology
  • Penn State Medical Group - Nyes Road – Specialties
  • Penn State Medical Group - Palmyra
  • Penn State Medical Group - Physical Medicine and Rehabilitation
  • Penn State Medical Group - Psychiatry
  • Penn State Sleep Research and Treatment Center
  • Penn State Surgical Weight Loss

Q: Does this affect patient co-pays or deductibles?

A: Depending on each patient’s specific insurance benefits, additional out-of-pocket expenses may be incurred under the “hospital outpatient” model.

Q: Where can patient call with their questions or concerns?

A: For more information, patients may contact our Patient Financial Services office toll-free at 800-254-2619.

Q: What can patients do if they are having difficulty paying for health care services?

A: Penn State Health Milton S. Hershey Medical Center and Penn State Medical Group offer discounting and charity policies to help qualifying patients and families. Additional information can be obtained by calling our Patient Financial Services office toll-free at 800-254-2619.

Hours of operation

Call Center Phone Lines:

  • Mon - Wed: 8 am - 5:30 pm
  • Thu - Fri: 8 am - 5 pm

Address

Penn State Health Milton S. Hershey Medical Center
Academic Support Building (map)
90 Hope Drive, Suite 2106
Hershey, PA 17033

Walk-in: 8 am to 4:30 pm