Effective August 1, 2023, Washington Regional Senior Health Clinic, Washington Regional Memory Disorders Clinic and Washington Regional Movement Disorders Clinic, all part of the Washington Regional Pat Walker Center for Seniors, will become outpatient departments of Washington Regional Medical Center. Hospital outpatient departments, also known as hospital-based outpatient clinics, are common models used by health care systems in our region, state and throughout the country. As a hospital-based outpatient clinic, the clinic will now be subject to additional safety and quality measures generally applicable to hospitals.

Below are answers to frequently asked questions related to this transition.

Q: What is a hospital-based outpatient clinic?
A: This term is used to describe a clinic that is part of a hospital and meets specific Medicare regulations.

Q: Does Washington Regional operate other hospital-based outpatient clinics?
A: Yes, Washington Regional currently operates other outpatient hospital clinics, including Washington Regional Balance Disorders Clinic and Washington Regional Wound Care Clinic.

Q. Why is Washington Regional converting the Senior Health Clinic, Memory Disorders Clinic and Movement Disorders Clinic to this model?
A. Hospital-based outpatient clinics have become a common model of practice for health systems in our region, state and throughout the country. This Medicare-approved model allows Washington Regional to be compensated for the unique services offered by these clinics, including providers and nurses who have specialized training in caring for seniors and adults with memory and movement disorders, as well as care managers and social workers.

Q. Will this change how I receive care?
A. You will continue to receive excellent, quality care from your provider. Additionally, your upcoming appointments and how you schedule appointments will not change. There will, however, be a change in laboratory services and in how Washington Regional bills your insurance carrier for services.

Q. How will laboratory services change?
A. On August 1, the Quest draw station inside of the Senior Health Clinic will transition to Washington Regional and be staffed by Washington Regional team members. All lab draws, whether performed on the day of your appointment or prior to your appointment, will need to be drawn at the Senior Health Clinic as of August 1. If you currently have a lab appointment scheduled with any Quest location outside of the Senior Health Clinic after July 31, please call us at 479.463.4444 to reschedule your appointment at the Senior Health Clinic.

Q: How does patient billing differ in a hospital-based outpatient clinic?
A: When you see a provider in a hospital-based outpatient clinic, there are two separate charges – one charge for the provider and one charge for the hospital/facility, similar to what you experience if you visit the emergency department. The addition of the hospital/facility fee may result in a greater out of pocket expense for you. If you have insurance, provider services are processed under physician/provider benefits and are generally subject to patient copayments, while hospital/facility services are processed under hospital benefits and are generally subject to separate deductibles and coinsurance amounts. Each insurance plan is unique, and some insurance companies may cover both hospital/facility charges and provider charges, and some may not.

Q: Will I receive two separate bills for my visit?
A: You will receive one statement from Washington Regional with separate charges for provider services and the hospital/facility fee.

Q: Will there be a hospital/facility fee charge for a telemedicine visit?
A: Yes, there will be a hospital/facility fee associated with a telemedicine visit. This charge is approved by Medicare for telemedicine visits through the end of 2024. Depending on your insurance plan, you may have an out-of-pocket expense for the hospital/facility charge. If you are a Medicare patient, the expense could range between $25 - $40 if you have not met your annual deductible.

Q: What if I have Medicare?
A: If you have Medicare Part A only, the hospital/facility fee will not be covered by Medicare. If you are a Medicare patient with Part B benefits, you will first need to meet your Part B deductible for provider services before the hospital/facility fee will be covered. If you have met your deductible, you will likely have no out-of-pocket expense. If you have not met your deductible, the hospital/facility fee will be an out-of-pocket expense of approximately $110. With Part B benefits, you will also be responsible for any coinsurance determined by Medicare.

Q: What if I have a Medicare Supplement Plan?
A: Medicare Supplement Plans are sold by private health insurance companies to help cover out-of-pocket expenses such as deductibles and coinsurance. You must have original Medicare, which includes both Part A and Part B, to purchase a Medicare Supplement Policy. The assistance with deductibles and coinsurance will vary depending on the benefits offered by your insurance plan; therefore, you could still be responsible for the hospital/facility fee as an out-of-pocket expense of approximately $110 if you have not met your annual deductible.

Q: What if I have Medicare with secondary insurance coverage?
A: Coinsurance and deductibles are typically covered by your secondary insurance. You will only be billed if the secondary insurance determines you are responsible for an out-of-pocket expense.

Q: What if I have a Medicare Advantage Plan?
A. Medicare Advantage plans will be subject to copays and/or deductibles as defined by your policy. You will be financially responsible for two separate co-pay amounts at the time of service – one for the office visit and one for the hospital/facility fee. Depending on your individual plan and time of year when seen, the hospital/facility charge could range between $106 - $118 if you have not met your annual deductible. You should check with your insurance carrier to determine if your plan covers hospital/facility charges in hospital-based outpatient clinics (please reference CPT code “G0463” when speaking to your insurance carrier). If you are concerned about being able to pay for health care services, you can contact a Washington Regional financial services representative at 479.265.9185 or click here to discuss financial assistance options.

Q: Who should I contact if I have specific questions regarding my insurance coverage for services at the Senior Health Clinic?
A: We recommend you call the clinic at 479.463.4444 within 5-10 days of your appointment to get the most up to date information about your financial responsibility.

Q: What can I do if I am having problems paying for health care services?
A: You can contact a Washington Regional financial services representative at 479.265.9185 or click here to discuss available options for financial assistance.