340B FAQs

Our goal is to improve your overall health care by better integrating our physician practices. We’ll keep our hospitals, physicians’ offices and other facilities, but we’ll use outside support staff to provide care. 

Provider-based billing, or hospital-outpatient billing, bills for services received in the hospital or for departments considered part of the hospital. These departments are part of Mercy, even if they’re located outside the actual hospital building. They meet our own standards and they meet federal accreditation.
 

Under hospital-outpatient billing, your visit is billed under the hospital instead of the clinic. Provider-based billing is a Medicare status for hospital departments that meet certain Medicare regulations. It also requires that we bill Medicare services in two parts:

• Physician services
• Hospital services

You'll see these appear as two separate charges on your billing statements. 

In a hospital-outpatient department, if you have Medicare, Medicare Advantage, Tricare or Medicaid, you may receive two explanation of benefits (EOBs) for any services provided:

• The first is for any physician services
• The second is for any hospital or facility resources

The combined total charge will be the same, but the individual components will be split into these two categories.

Depending on your coverage, it's possible costs will differ for some services and procedures. Some patients may pay more out-of-pocket due to their health plan's coinsurance and deductible. Reach out to your insurance company directly to better understand your coverage by letting them know that your doctor’s office has recently changed from a “clinic” to an “outpatient hospital-based department.”

In some situations, your coinsurance and deductible may be covered by a secondary insurance policy. Contact your insurance company for your benefit details. 

For questions regarding your insurance benefits, contact your insurance company and let them know that your doctor's office has recently changed from a "clinic" to an "outpatient hospital-based department."
 

If you have additional questions, you may send an inquiry through our MyMercy+ customer service messaging center or call Mercy Billing Customer Service at 855-420-7900. 

If you're having trouble paying for your health care services, please reach out to Mercy Financial Assistance at 855-420-7900or visit mercy.net/FinancialHelp for more information.