Thank you for choosing Lexington Medical Center as your health care facility to assist with your health care needs.
We share this note to inform you of changes being made in our billing policies for the Hospital. Similar to the changes being made at academic medical centers and community hospitals across the country, Lexington Medical Center is taking a more active role in the care delivered within ambulatory clinics, and as a result is converting some of its physician clinics to hospital-based outpatient clinics. Hospital-based outpatient clinics are organized to promote increasing collaboration between hospitals and physicians in order to better serve your health care needs by emphasizing joint attention to quality, coordination of care, and exceptional clinical outcomes.
Under our new policies, patients will continue to receive a bill from the doctor but may also receive a separate bill for some “hospital-based services” provided by Lexington Medical Center. The amount you owe for your care will be determined by the actual services received from the hospital and the doctor, and the source of the billing will depend on which organization delivered the service -- for example, laboratory work and x-rays are provided by the hospital and will thus be billed by Lexington Medical Center as “hospital-based services” even though they are delivered in an outpatient clinic environment; and professional services for care provided by your doctor will be billed as “physician services” by the physician group (Community Physicians).
With these changes, patients may receive two statements from their insurance carrier, one being for hospital-based services and the other for physician services. These statements will show any amount that is owed for the visit, that amount being determined by your insurance plan’s specific benefits. Medicare patients will owe an additional co-insurance payment for the “hospital-based” ambulatory clinic visit, though many Medicare patients have a supplemental policy that may cover any additional expenses that might be incurred. Medicare patients may also owe a co-insurance payment for the doctor visit, though this also may be covered by your supplemental policy. Adult Medicaid patients may be (excluding OB) required to pay two copayments - $3 for the physician service and $3 for the hospital-based service – Medicaid patients under the age of adulthood will continue to pay only one $3 copayment (if applicable).
As your health care provider, we are committed to offering you the best care possible. We are also committed to helping you understand our financial and billing policies, so if you have questions regarding these billing policy changes, please feel free to call our Patient Business Services Staff at 336-238-4765.