Provider-Based Clinics FAQs

Provider-Based Clinics FAQs

Here are answers to some of the most commonly asked questions about Practice-Based Clinics.

What is a Provider-Based Clinic?

A Provider–Based Clinic is a Medicare status for hospitals and clinics that provide integrated services and meet specific Medicare regulations. As a Provider-Based Clinic, the practice will be considered a department of Rush Copley Medical Center.

As a Medicare patient, how will this affect my next visit?

We want to reassure you that your care will not be affected and the doctors and services at this location will remain the same. You will however notice a change on your bill. Medicare patients who receive services from any of the following practices: Rush Copley Cardiovascular, Rush Copley Gastroenterology, Rush Copley Oncology, Rush Copley Radiation Oncology, Rush Copley Family Medicine Center and Rush Copley Pulmonary and Sleep Medicine after October 1, 2020, will now receive two separate statements:

  • One for the physician services (professional fee)
  • One for the cost of operating the clinic (facility fee)

You will also receive two Medicare Summary Notices (MSNs) from Medicare, one for the professional fee and one for the facility fee. The processing of the claims will remain the same. Once Medicare has processed their portion of the charges, the balance will be submitted to a secondary payer. 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. This billing model is called Provider-Based. It complies with specific Medicare regulations and is a national model of practice for integrated healthcare delivery systems.

What if I have a question about my bill?

If you have questions about your bill, please call the Rush Copley Billing Office at (630) 978-4990.

Why is the practice being converted to a Provider-Based Clinic?

The rising cost of health care and lower reimbursement prompted Rush Copley to make this change at this location. This Medicare approved provider-based model helps ensure that Rush Copley is fairly compensated for the services we provide.