Services & Specialties December 18, 2013

Adena Regional Medical Center Transitions to Provider-based Designation in 2014

On Jan. 1, 2014, Adena Regional Medical Center (ARMC) will change to the Medicare provider-based designation model, a common practice in the healthcare industry that separates the charges for physician services and facility utilization. The change only impacts patients insured by Medicaid and Medicare. In addition, physician locations will become departments of ARMC. There will be no change in staff or services.

With the provider-based model, those insured by Medicare will likely receive two bills from ARMC for services provided. The first for “professional services,” which cover the medical care provided to patients by an Adena doctor or health professional. The second is a “facility charge,” which covers the cost of outpatient hospital space, exam rooms and equipment, operations, medical recordkeeping, and other services provided by the hospital. Some Medicare patients may also experience a slight change in their co-pay or out-of-pocket expenses. Medicaid will be billed separately for these services as well.

“The provider-based model is an increasingly common way for hospitals to operate their outpatient facilities,” said Lloyd Eichenlaub, Adena’s Manager of Reimbursement. “The change to a provider-based model offers ARMC a more strategic way to manage its resources for the overall benefit of our patients.”

Finally, the hospital’s longstanding mission of providing quality care to our community, regardless of their ability to pay, will be extended to its physician clinic departments beginning Jan. 1, 2014. Previously, Charity Care had only been provided in the hospital setting.

Patients with questions or difficulties in paying for any healthcare service may contact ARMC’s Patient Financial Services office at (740) 779-7960.