Frequently Asked Questions

What does "hospital-based clinic" mean?

Medicare has designated clinics of employed providers on hospital campuses “hospital-based” clinics. Employed providers are defined as physicians, physician assistants and nurse practitioners. Hospital-based clinics must meet specific Medicare rules and high standards regarding quality, coordination of care and clinical outcomes. Many hospitals and clinics in Louisiana and around the nation have adopted this model of care.

Why are the clinics converting? How will this benefit me?

These clinics are converting because they are physically located on the North Oaks Medical Center campus.

Patient Benefits:

• The clinics will gain additional resources for use in your care not previously available to them.
• This model, which is nationally supported by Medicare, fosters a unified environment where hospital and clinic providers work more closely together in your care.
• The clinics will now have the additional advantage of participating in The Joint Commission (TJC) accreditation process as part of North Oaks Medical Center, which has earned TJC’s Gold Seal of Approval™. TJC works to improve health care for the public and helps organizations provide safe, effective care.

Are all clinics of North Oaks-employed providers becoming hospital-based clinics?

No. Only provider clinics that are physically located on the North Oaks Medical Center main campus in Hammond will become hospital-based clinics. The North Oaks hospital-based clinics include:

• Magnolia Obstetrics & Gynecology
• North Oaks Cardiology
• North Oaks Endocrinology
• North Oaks ENT & Allergy
• North Oaks Eye Care
• North Oaks Infectious Disease
• North Oaks Neurology Clinic
• North Oaks Neurosurgery Clinic
• North Oaks Orthopedic Specialty Center
• North Oaks Pain Management Clinic
• North Oaks Primary Care - Hammond
• North Oaks Pulmonology
• North Oaks Rheumatology
• North Oaks Trauma
• North Oaks Surgical Associates
• Northshore Internal Medicine Associates
• Perinatology

If you’re unsure of the status of your provider’s clinic, be sure to ask when scheduling your appointment, and we will be happy to verify whether or not your provider’s clinic is considered a hospital-based clinic.

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How does the billing process change for hospital-based clinics?

Currently, when you see a health care provider in a private office setting, the fees for all services are filed to your insurance provider on one bill. Depending upon your insurance, you may notice a change in the way you are billed. After June 11, patients may receive two separate bills for services - just as you would for an emergency room visit or radiology procedure:

a bill for your provider’s professional services
a bill for technical services (e.g., facility/exam room usage, X-rays, blood work).

Your copayment may change for certain outpatient services and procedures at our hospital-based clinics. Coinsurance and deductibles may be covered by a secondary or supplemental insurance policy. Please check with your insurance provider for detailed answers related to secondary insurance.

Where can I get further assistance with my questions or concerns?

North Oaks Financial Assistance Center has Financial Counselors available to assist you with your billing questions at (985) 230-2580.

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