Hospital-Based Outpatient Billing

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

Questions about coverage

800-254-2619

Questions and Answers

Penn State Health 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 Health Medical Group “Hospital-Based Outpatient” locations may result in a hospital charge, as well as a physician charge for outpatient services and 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 covers and identify any out-of-pocket expenses.

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 billing statements.

Q: Why use this billing process?

A: Patients admitted to the hospital or seen in outpatient practices on the Medical Center’s campus have historically received two (2) charges on their bill. Following this 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 providers to determine what their policy covers and what out-of-pocket expenses patients may incur. Please note that some clinical lab tests 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 Health Medical Group - Briarcrest 
  • Penn State Health Medical Group - Camp Hill 
  • Penn State Health Medical Group - Elizabethtown
  • Penn State Health Medical Group - Fishburn Road
  • Penn State Health Medical Group - Harrisburg
  • Penn State Health Medical Group - Lime Spring (first floor suites)
  • Penn State Health Medical Group - Mechanicsburg
  • Penn State Health Medical Group - Middletown
  • Penn State Health Medical Group - Mount Joy
  • Penn State Health Medical Group - Nyes Road 
  • Penn State Health Medical Group - Palmyra
  • Penn State Health Medical Group - Physical Medicine and Rehabilitation
  • Penn State Health Medical Group - Psychiatry
  • Penn State Health Sleep Research and Treatment Center
  • Penn State Helth 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 patients call with 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 Health Medical Group offer discount 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 Hours

  • Monday - Friday: 8 a.m.-5 p.m.

Walk-in Hours

  • Monday - Friday: 8 a.m.-5 p.m.

Address

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