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Jennie Stuart Health Provider-Based Clinics

Dear patient,

Jennie Stuart Medical Group offices converted to provider-based outpatient departments of Jennie Stuart Medical Center effective December 5, 2022. This clinical integration allows for higher quality and seamlessly coordinated care.  

Provider-based outpatient clinics (also known as Hospital-based outpatient clinics) are considered a department of the hospital; "private" provider offices are not (generally, these are smaller physician offices in the community) – like the Jennie Stuart Medical Group offices. 

Clinics located miles away from the main hospital campus may still be considered part of the hospital. Provider-based outpatient clinics are subject to stricter government rules, making them more complex and more costly to operate. When you see a provider or receive services in a provider-based outpatient clinic, you are technically being treated within the hospital rather than the private office. 

The following Jennie Stuart Medical Group offices will become departments of Jennie Stuart Medical Center: 

  • Jennie Stuart Family Health (all locations)
  • Jennie Stuart Obstetrics & Gynecology (all locations)
  • Jennie Stuart General Surgery (all locations)
  • Jennie Stuart Dermatology
  • Jennie Stuart Gastroenterology
  • Jennie Stuart Orthopedics
  • Jennie Stuart Urology
  • Jennie Stuart Ear, Nose, & Throat
  • Jennie Stuart Medical Oncology
  • JennieCare Urgent Care & Occupational Health

You will notice new signs at these offices designating that they are: "Departments of Jennie Stuart Medical Center"

Frequently Asked Questions

  • What is different about a provider-based outpatient clinic?
  • How does provider-based billing affect the billing process?
  • Does this apply to patients with private insurance like Anthem, Cigna, and Aetna?
  • Will this affect my copays, co-insurance, or deductible?
  • What if Medicare patient has secondary insurance coverage?
  • Why does the Medicare Secondary Payer (MSP) questionnaire need to be completed?
  • What can patients do if they have questions about their bill?
  • What can patients do if they may have difficulty paying for healthcare services?

A provider-based outpatient clinic refers to services provided in hospital outpatient departments that are clinically integrated into a hospital. According to Medicare billing rules, when you see a provider in a provider-based outpatient clinic, the provider and hospital charges are billed separately. For patients with insurance, provider services are processed under physician benefits, which are generally subject to patient liabilities in the form of copayments, while hospital services are processed under hospital benefits subject to deductibles and coinsurance amounts.

Provider-based status is a Medicare status for hospitals and clinics that meet specific Medicare regulations and requires that we bill Medicare (to include some Medicare Advantage plans and Medicaid) in two parts. For patients with certain insurance coverage, your billing statement for each visit or service you receive will show:

  • One charge for the professional services rendered by the provider you see; and
  • One charge for the facility, which covers the use of the room and any medical or technical supplies, equipment, and support staff
For most patients, both charges add up to the same amount previously charged to all patients for the same service.

 

Many private insurance companies do not require that we follow the same billing rules required by Medicare. For patients with private insurance, the facility component of the provider office visit will be billed as part of the provider bill and will be processed by the insurance under the patient’s physician benefits.

Depending on the clinical services being provided, additional out-of-pocket expenses may be incurred in the provider-based clinic. Insurance benefits vary significantly by insurance company. Ask your insurance company if your benefit plan covers facility charges in a provider-based outpatient clinic and how much of the charge is covered or will it be applied to your deductible or subject to coinsurance. Co-insurance and deductibles may be covered by a secondary insurance policy.

You will continue to receive excellent quality care from the same providers who you have come to know and trust. Scheduling for appointments will not change.

Co-insurance and deductibles may be covered by a secondary insurance. Check your benefits or with your insurance company for details.

As a participating Medicare Provider, we are required to screen Medicare patients according to the MSP rules. At each visit, you will be asked the MSP questions. These questions help us confirm if Medicare or another payer should process your insurance claim as primary. It only takes a few minutes to complete the questionnaire.

Questions about your provider office bill can be directed to our business office at 270-707-2100.

Consistent with our mission to provide high quality health and wellness services for the community, Jennie Stuart Medical Center is committed to providing affordable care to our patients and as such offers financial assistance programs. Jennie Stuart Medical Center will not pursue extraordinary collections actions against an individual without first using reasonable efforts to determine if such individual is eligible for financial assistance.

Financial Counselors are available Monday through Friday from 7:00am until 3:30pm to discuss the Financial Assistance application process at 270-887-0332 or 270-887-0100 ext. 4505.
A copy of the full Financial Assistance Policy and/or application can be obtained online at https://www.jenniestuarthealth.org/Patient-Visitors/Financial-Assistance-Guidelines or by request.

 

Provider-Based Clinic Locations

Dermatology
10755 Eagle Way, Suite 202
Hopkinsville, KY 42240
(270) 887-5640
Fax (270) 886-5371

ENT
10755 Eagle Way, Suite 201
Hopkinsville, KY 42240
(270) 807-5430
Fax (270) 887-0915

Family Health
MAIN CAMPUS
222 West 18th St.
Hopkinsville, KY 42240
(270) 886-4625
Fax (270) 886-6619

Family Health
BYPASS
223 Burley Ave.
Hopkinsville, KY 42240
(270) 887-6565
Fax (270) 887-6575

Family Health
TRENTON
120 N. Main St.
Trenton, KY 42286
(270) 466-9300
Fax (270) 466-3300

Gastroenterology
231 Burley Ave
Hopkinsville, KY 42240
(270) 885-7300
Fax (270) 885-7198

General Surgery
1724 Kenton St., Suite 2B
Hopkinsville, KY 42240
(270) 632-4555
Fax (270) 270-632-4556

General Surgery
1722 High St.
Hopkinsville, KY 42240
(270) 885-8505
Fax (270) 885-8564

JennieCare Urgent Care
BYPASS
10755 Eagle Way Suite 100
Hopkinsville, KY 42240
(270) 887-0270
8am-7pm (Monday-Friday)
9am-6pm (Saturday & Sunday)

Medical Oncology
1717 High Street Suite 1S
Hopkinsville, KY 42240
(270) 885-0570

Obstetrics and Gynecology
1717 High St., Suite 4B
Hopkinsville, KY 42240
(270) 887-9058
Fax (270) 887-9341

Orthopaedics
10755 Eagle Way, Suite 200
Hopkinsville, KY 42240
(270) 889-0701
Fax (270) 889-0556

Pediatrics
222 W. 18th St.
Hopkinsville, KY 42240
(270) 886-4625
Fax (270) 886-6619

Urology
1724 Kenton Street, Suite 1C
Hopkinsville, KY 42240
(270) 886-5141
Fax (270) 885-1877

*No one will be denied access to services due to inability to pay. There are discounts available based on family size and income.