Provider-Based FAQ

What does “Provider-Based” or “Hospital-Based” mean?

"Provider-Based” or “Hospital-Based Outpatient” refers to the billing process for services rendered in a hospital outpatient clinic or location. This is the national model of practice for large, integrated delivery systems involved in patient care.

 Why does Adirondack Health do “Provider-Based/Hospital Based” billing?

Adirondack Health employs many physicians and the same type of billing process is utilized for our outpatient care at Adirondack Medical Center - Saranac Lake, Adirondack Medical Center - Lake Placid, and our off-campus locations. This ensures an appropriate payment for the services provided by employed hospital physicians and staff.

Does this mean that a patient will pay more for a service rendered?

Coverage and patient responsibility is dependent upon a particular insurance coverage and it is possible a patient may pay for certain outpatient services that are provided in our provider-based/outpatient locations than at a free-standing facility or physician’s office.

What are Adirondack Health’s Provider/Hospital Based outpatient locations?

Does this affect copay/coinsurance/deductible?

It is dependent upon the patient’s insurance and could be less, the same, or more compared to a free-standing facility.

Receiving care at Adirondack Health provider-based locations may result in a facility charge as well as a physician charge for outpatient services and procedures. These charges will be reflected on your patient statement and explanation of benefits from the insurance company.