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Provider-Based Billing

Medicare patients only

If your insurance is provided by Medicare, receiving care at one of Campbell County Medical Group’s Clinics (or provider-based locations) may result in a facility charge as well as a professional or physician charge for outpatient services and/or procedures.

Depending on your insurance coverage, you may pay more for services and procedures. You are welcome to call Patient Financial Services at 307-688-2690 to receive an itemized statement, which will reflect these charges. This billing process is not unique to Campbell County Health or to our Clinics—it is happening in many health care systems across the country.

Charges may be seen for the following

What is provider-based billing (PBB)?

PBB refers to the billing process for services rendered in a hospital outpatient clinic or department. This is the national model of practice for integrated health care systems where the hospital owns space, and employees support personnel involved in patient care. This billing model also is known as hospital outpatient billing.

Will there be a change in how patients receive care?

No. You will continue to receive excellent, quality care from the providers you have come to know and trust. Scheduling for appointments and tests will not change.

How does PBB affect the billing process?

Charges for services are the same for all insurance providers. Under the PBB model, you may potentially receive two (2) charges. One charge represents the facility or hospital charge, and one charge represents the professional or physician fee. All other insurance health plans and networks do not require charges be shown and billed separately. They are listed as one charge.

Please call Patient Financial Services at 307-688-2690 to receive an itemized statement, which will reflect these charges.

Please note: Medicare beneficiaries are responsible for the co-insurance amount on the services you receive. These amounts are determined by Medicare and are based on the services performed.

Will Medicare patients pay more for services?

Depending on your particular insurance coverage, it’s possible you may pay more for certain outpatient services and procedures at our provider based/clinic locations. We recommend that 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. Some Medicare patients may be covered by supplemental insurance and may not have to pay more out-of-pocket.

Are all patients billed using provider-based billing?

Listing facility charges and professional services separately is required by the Centers for Medicare and Medicaid (CMS). Only patients with Medicare and select Medicare Advantage plans are billed with the PBB method. All other insurance health plans and networks do not require charges be shown and billed separately—it’s just one charge.

Who do I contact if I have questions about my insurance coverage?

Please contact your insurance provider.

Questions or concerns?

Contact a Campbell County Health Patient Financial Services representative today at 307-688-2690 or pfs@cchwyo.org for more information or for answers to your questions and concerns.

Zero Interest Payment Option

Campbell County Health provides the ClearBalance® patient-friendly payment option. The program is a zero-interest revolving credit account with flexible payment terms. Use the ClearBalance program to manage your out-of-pocket expenses, including deductibles and insurance copayments, for care at Campbell County Health and Powder River Surgical Center. Call us for more information: 307.688.1482. Learn more

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