Thank you for choosing Fox Chase Cancer Center and Health Services of FCCC for your healthcare needs.
Fox Chase Cancer Center and its affiliated physician network have been designated as "Hospital-Based" organizations. For Medicare recipients, this designation affects the way your account is billed to Medicare. Fox Chase is committed to providing exceptional and compassionate healthcare services, including billing Medicare or your insurance provider on your behalf for all services rendered.
For more information about Hospital-Based Billing, please call
Frequently Asked Questions about Hospital Based Billing
What does the "Hospital-Based" designation mean?
Medicare and insurance companies recognize integrated healthcare delivery systems, like Fox Chase Cancer Center, in a distinct way. The term "Hospital-Based" is derived from special rules that Medicare developed. Under these rules, if a physician's practice is owned by a hospital, then his/her practice can be designated as "Hospital-Based" and the physician is paid under hospital outpatient department rates.
Fox Chase Cancer Center owns the medical practice of Health Services of FCCC. Under this agreement, Medicare and insurance providers now recognize Health Services of FCCC as a department of Fox Chase Cancer Center, i.e., the term "Hospital-Based."
How does the "Hospital-Based" status affect me?
When seeing a Health Services physician for any type of outpatient services, i.e., office visits, treatment, etc., you will see a change in the way you are billed. Under "Hospital-Based" status, Medicare and insurance providers require us to bill all Hospital-Based physician services in two parts.
- A physician fee billed by Health Services of FCCC.
- An outpatient facility services fee billed by Fox Chase Cancer Center.
When your medical services are completed, our billing staff will submit two claim forms to Medicare or your insurance company for physician services on your behalf. A bill from Health Services of FCCC for the physician charge and one from Fox Chase Cancer Center for the outpatient facility charge.
Medicare recipients: You will receive two Medicare Summary Notices (MSN) from Medicare. Once Medicare has paid their portion of the charge, the balance will be submitted to a secondary payor. If there is a balance after the secondary insurance processes the claim, or if you do not have secondary insurance, you will receive a bill for the remaining balance.
Please note: With this billing process, there is no increase in charges being billed to Medicare for patients using Health Services of FCCC services. However, Medicare's allowable amount may be different, which may increase your co-payment, coinsurance or deductible portion depending on your insurance. If a balance remains after insurance carrier payments, you will receive a monthly statement and payment is due within 30 days following the date of billing.
What is the process for submitting a Medicare claim?
All medical providers, both hospitals and physicians, are required to screen Medicare patients according to Medicare Secondary Payor rules. At each visit, Clinic staff may ask you to complete, or update, a "Medicare Secondary Payor" questionnaire. The answers to these questions confirm that either Medicare, or another payor, is the primary payor.
Throughout the billing process, our staff will work with Medicare to ensure your claims are processed correctly. In summary, the submission of claims to Medicare will include two claim forms, one for the physician service and a second for the facility or hospital charge (including laboratory and X-ray services).
Does this mean patients will pay more for services?
Most Medicare patients will be covered by their supplemental insurance and will not have to pay more out-of-pocket. Medicare patients without supplemental insurance will pay a small amount.
For patients with commercial insurance: depending on their particular insurance coverage, it is possible patients may pay more for certain outpatient services. We recommend patients review their insurance benefits or contact their insurance provider to determine what their policy will pay and what out-of-pocket expenses they may incur.
What type of questions should I ask my health insurance company?
Ask your health insurance company whether it covers facility charges or provider-based billing. If it does, ask what percentage of the charge is covered and if you will have a co-pay.
Does this affect patient co-pays or deductible?
Depending on each patient's specific insurance benefits, additional patient out-of-pocket expenses may be incurred by the hospital-based model.