Provider-based clinic billing is a long-standing practice that has been in place for more than 25 years and is used by many health systems in the state and nationwide. Like these other hospitals, we transitioned the specialty clinics to provider-based clinics, also known as hospital outpatient departments, on November 24, 2025.
Now that our provider-based clinics are part of the hospital, they’ll be meeting all federal accreditation standards, helping ensure you receive the highest quality of care by specialists we’re fortunate to have caring for our communities in rural Nebraska.
We understand that healthcare billing can be complex and changes in how services appear on a bill may raise questions for patients. While services may be billed differently under this model, the cost of care varies depending on the type of service provided and each patient’s insurance coverage.
What is a provider-based clinic?
The term “provider-based clinic” is a federal classification used to describe clinics that are part of the hospital even if the service location isn’t directly in or attached to the hospital. The Centers for Medicare & Medicaid Services (CMS) has specific guidelines to differentiate provider-based clinics and their billing practices. This means your bill for provider-based clinics will feature two separated charges, rather than the one bundled charge, that is used in physician-based clinics. Provider-based clinics must comply with Medicare facility accreditation standards and are surveyed on a regular basis to ensure compliance with standards.
Will my provider or care change?
No. Rest assured, you will still receive care from the same trusted team of providers and staff you know and trust.
Why provider-based clinics?
Operating provider-based clinics helps keep Faith Health strong as the regional referral center of northeast Nebraska. As a non-profit hospital, our emergency services are open 24/7 to care for everyone who comes through our doors. This designation allows us to operate more efficiently, maintain higher quality standards, and ensure patients have access to the care they need. This change supports our ability to keep vital services and specialists in the community to provide you and your family with access to comprehensive, high-quality care close to home.
How will this affect my bill?
Your bill will look different as it will be broken out into two sections. According to CMS health care billing rules, when a patient sees a physician or advanced practice provider in a provider-based clinic, provider and hospital charges are to be billed separately.
After a visit in a provider-based clinic, patients will see their bill split into two parts:
1. Professional Fee: For the care you received from your doctor or advanced practice provider.
2. Technical Fee: For the clinic, its equipment and staff support during your visit.
Depending on the patient’s specific insurance coverage, it is possible that benefits will differ for services and procedures at our provider-based clinic locations. For patients with insurance, physician services are processed under physician benefits, which are generally subject to patient copayments, while hospital services are processed under hospital benefits and subject to deductibles and coinsurance amounts. Please contact your health insurance company if you are unsure about your specific benefits or have insurance coverage questions.
What should I ask my insurance carrier?
Many insurance plans cover facility charges in provider-based clinics. To understand what you may owe, ask your insurance how much they will cover and whether any of the cost will go toward your deductible or require you to pay a percentage (coinsurance).
Does this mean patients will pay more for services?
Patient responsibility is dependent on their specific type of insurance coverage. Some plans treat hospital-based visits differently than traditional office visits. It is possible to pay more or see no change for certain outpatient services and procedures at provider-based clinics. We advise you to review your insurance benefits and reach out to your insurance company to determine what your out-of-pocket expenses will be.
How do I know what my cost of care will be?
There are many different ways to get price estimates for services at Faith Health. There is a price estimator tool on our website that provides estimates by payer for many common services. Our Electronic Health Record (EHR) app, MyChart, has a section where you can receive an estimate. For scheduled procedures, you may request an estimate at the time of scheduling. You may also request an estimate at the time of service when you register. Estimates can also be provided during business hours at (402) 371-4880 by one of our billing support specialists.
What if I have a Medicare secondary insurance?
Coinsurance and deductibles may be covered by a secondary insurance. Please check your carrier benefits or ask your insurance company for details.
Does this affect co-pays or deductibles?
This depends on each patient’s specific insurance benefits. You may have a copay, coinsurance, or deductible that applies differently. Additional out-of-pocket expenses may be incurred in a provider-based clinic. Medicare patients may incur a coinsurance cost to the hospital.
How will I know if a clinic is a provider-based clinic?
Signs are posted in each clinic that is considered a provider-based clinic. Nearly all Faith Health clinics, with the exception of Family Medicine, Ophthalmology, Pediatrics and Urgent Care operate as provider-based clinics.
What is the difference between EOB and a bill?
When you receive medical care, you may get two different documents: an Explanation of Benefits (EOB) and a bill. They are not the same, and it’s important to know the difference. An Explanation of Benefits (EOB) is a statement from your insurance company. An EOB is not a bill. It is for your information only to explain what services you received, how much your provider charged, what your insurance plan paid and what portion you may owe. A bill comes from your doctor, hospital, or healthcare provider. This is the amount you are responsible for after your insurance processes the claim. You should only pay a bill—not the EOB.
What affects the amount I owe?
Several factors determine your patient responsibility (what you owe).
Insurance Coverage: Your plan decides which services are covered and how much they will pay.
Deductible: The amount you must pay out of pocket each year before your insurance starts paying.
Copay (Copayment): A fixed amount you pay for certain services (for example, $25 for a doctor visit).
Coinsurance: Your share of the cost after your deductible is met (for example, 20% of the bill).
In-Network vs. Out-of-Network Providers: Visiting providers in your insurance network usually costs less.
How does Faith Health send bills to patients?
Patients who have a MyChart account are automatically enrolled in paperless billing. You may opt out of paperless billing and request a bill by updating your preferences under the Billing tab on MyChart or by calling our Billing Support Specialists at (402) 371-4880. You may be called by a member of our team to ask about outstanding balances. This is intended to assist you in making a payment or to in setting up a manageable payment plan. Our goal is to support you in resolving your balance – not to send your account to collections.
Who can I call with financial questions or if I am having difficulty paying for health care services?
We understand provider-based billing can be a complicated system and encourage you to call our Patient Financial Services Department at (402) 371-4880, available Monday-Friday 8:00 a.m. to 5:00 p.m., if you have any questions related to billing.
If you have questions about your bill or are having trouble paying for care, our team is here to help. You can set up a payment plan through the MyChart app anytime, call our Billing Support Specialists at (402) 371-4880 or speak with one of our Financial Counselors Monday-Friday 8:00 a.m. to 5:00 p.m.
We understand that some patients need flexible options. We can help you set up a payment plan, and for longer-term needs, we may connect you with a local bank for additional financing options. We also offer financial assistance for those who qualify. Our team is also here to assist you with applying for Medicaid if needed. We welcome you to visit with a Financial Counselor regarding your needs in person at 2700 W. Norfolk Avenue or by calling at (402) 644-7366, Monday-Friday 8:00 a.m. to 5:00 p.m.
402-371-4880