Frequently Asked Questions
Q. What does "hospital-based clinic" mean?
A. Medicare has designated clinics of employed providers on hospital campuses
“hospital-based” clinics. Employed providers are defined as
physicians, physician assistants and nurse practitioners. Hospital-based
clinics must meet specific Medicare rules and high standards regarding
quality, coordination of care and clinical outcomes. Many hospitals and
clinics in Louisiana and around the nation have adopted this model of care.
Q. Why are the clinics converting? How will this benefit me?
A. These clinics are converting because they are physically located on
the North Oaks Medical Center campus.
Patient Benefits
- The clinics will gain additional resources for use in your care not previously
available to them.
- This model, which is nationally supported by Medicare, fosters a unified
environment where hospital and clinic providers work more closely together
in your care.
- The clinics will now have the additional advantage of participating in
The Joint Commission (TJC) accreditation process as part of North Oaks
Medical Center, which has earned TJC’s Gold Seal of Approval™.
TJC works to improve health care for the public and helps organizations
provide safe, effective care.
Q. Are all clinics of North Oaks-employed providers becoming hospital-based clinics?
A. No. Only provider clinics that are physically located on the North Oaks
Medical Center main campus in Hammond will become hospital-based clinics.
The North Oaks hospital-based clinics include:
- Magnolia Obstetrics & Gynecology
- North Oaks Endocrinology
- North Oaks ENT & Allergy
- North Oaks Eye Care
- North Oaks Family Medicine, Main Campus
- North Oaks Infectious Disease
- North Oaks Neurology Clinic
- North Oaks Orthopaedic Specialty Center
- North Oaks Pain Management Clinic
- North Oaks Primary Care - Hammond
- North Oaks Pulmonology
- North Oaks Rheumatology
- North Oaks Shock Trauma
- North Oaks Surgical Associates
- Northshore Internal Medicine Associates
- Perinatology
- Plaza Orthopedics
If you’re unsure of the status of your provider’s clinic, be
sure to ask when scheduling your appointment, and we will be happy to
verify whether or not your provider’s clinic is considered a hospital-based clinic.
Q. How does the billing process change for hospital-based clinics?
A. Currently, when you see a health care provider in a private office setting,
the fees for all services are filed to your insurance provider on one
bill. Depending upon your insurance, you may notice a change in the way
you are billed. After June 11, patients may receive two separate bills
for services - just as you would for an emergency room visit or radiology
procedure:
- a bill for your provider’s professional services
- a bill for technical services (e.g., facility/exam room usage, X-rays,
blood work).
Your copayment may change for certain outpatient services and procedures
at our hospital-based clinics. Coinsurance and deductibles may be covered
by a secondary or supplemental insurance policy. Please check with your
insurance provider for detailed answers related to secondary insurance.
Q. Where can I get further assistance with my questions or concerns?
A. North Oaks Financial Assistance Center has Financial Counselors available
to assist you with your billing questions at (985) 230-2580.