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Billing for Hospital-Based Clinics

Many clinics at University of Iowa Health Care are hospital-based (also known as provider-based) outpatient clinics. This means you are being treated using doctor care and hospital care. This helps us provide you with high quality, seamlessly coordinated care.

Doctor care (also known as professional services) and hospital care must be billed separately, even though they happen at the same time, so your bill may have charges for:

 

Professional fees
  • Services of a health care provider during a clinic visit or procedure
  • Reading of test results
Facility fees
  • Room, equipment, supplies, testing, nursing, etc. for a clinic visit or procedure
  • Tests, labs, and imaging

During a wellness or preventative visit, which is covered by most health plans at no cost to you, your provider may decide additional services are needed. This may change the way your visit is billed, and is based on your diagnosis, services given, problems addressed, and length of visit. 

The above may lead to higher out-of-pocket costs for you, such as higher:

  • Copay
  • Coinsurance
  • Deductibles

Please review your health care benefits or call your insurance. They can tell you if your plan covers facility fees in a hospital-based clinic. Helpful questions to ask are:

  • How much of the charge is covered?
  • How much will be put toward my deductible or coinsurance?
  • What tier of my benefits plan will apply at this location?

Download Hospital-Based Clinics Informational Handout

List of new hospital based billing locations (former Mercy Iowa City locations)

Has your clinic you visit changed to hospital-based billing? What you need to know

When a clinic or health care facility uses a hospital-based billing model (also known as provider-based billing), it means that patients are being treated as part of a hospital - using both doctor care (also known as professional services) and hospital care (also known as technical services). These must be billed separately, even though they happen at the same time.

Switching the clinics to hospital-based ensures they are fully integrated with the existing hospital departments to provide the highest quality, most seamless coordinated care available.

Doctors fees or professional fees are services of a health care provider during a clinic visit or procedure, including the reading of test results.

Hospital fees include things like room, equipment, supplies, testing, nursing, etc. for a clinic visit or procedure performed in hospital space. This also includes things like tests, labs, and imaging.

During a wellness or preventative visit, which is covered by most health plans at no cost to you, your provider may decide additional services are needed. This may change the way your visit is billed, and is based on your diagnosis, services given, problems addressed, and length of visit.

Depending on your insurance or health plan, hospital-based billing may lead to higher out-of-pocket costs for you, such as a higher copay, coinsurance, or deductibles. It is recommended that you review your health care benefits or call your insurance. They can tell you if your plan covers facility fees in a hospital-based clinic.

While you are not required to, it is recommended that you review your health care benefits or call your insurance. They can tell you if your plan covers facility fees in a hospital-based clinic. Helpful questions to ask are:

  • How much of the charge is covered?
  • How much will be put toward my deductible or coinsurance?
  • What tier of my benefits plan will apply at this location? 

For more information on hospital-based billing, you can visit https://uihc.org/billing-hospital-based-clinics 

If you have questions about your bill, please contact:

Patient Billing Services

Monday through Friday, 8 a.m. to 5 p.m.

Phone: 319-384-2196 or 866-393-4605

Email: [email protected] 

If you have questions about your bill, please contact:

Patient Billing Services
Monday through Friday, 8 a.m. to – 5 p.m.
Phone: 319-384-2196 or 866-393-4605
Email: [email protected]

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      • Billing, Insurance, and Records FAQs
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        • Billing Checklist
        • Billing for Hospital-Based Clinics
        • How to Read Your Bill
        • Pay Your Bill - Options and Steps
        • Your rights and protections against surprise medical bills
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Patient Billing

To make payment arrangements or discuss financial assistance, please contact:

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  • Email: [email protected]
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