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Provider-Based Billing

(757) 668-8931

Below are answers to questions that parents may ask about provider-based billing.

Q: What is changing?

A: CHKD is moving to a billing system called provider-based billing. This means that with certain kinds of insurance, bills for outpatient services delivered in a department that is considered part of the hospital will be split into two parts. One part will cover the physician or surgeon’s services and the other part will cover the hospital’s charges for operating the clinic, such as non-physician staff, medication and supplies.

Some hospital departments are located within the hospital, but some are located at CHKD Health Centers miles away from the hospital. Because they are considered part of the hospital, these locations uphold the same safety and quality standards as the rest of the hospital.

Q: Who is affected?

A: This change only applies to those with the following types of insurance/payment:

  • Medicare
  • Virginia Medicaid
  • VA Premier
  • Healthkeepers Plus
  • NC Medicaid
  • Tricare
  • Self-pay

Q: Will I have to pay more?

A: Your total charges should stay the same but you may receive two bills or two “Explanation of Benefits” documents.

Q: Why is CHKD doing this?

A: This is a national billing model for organizations like CHKD that offer hospital-level outpatient care in a variety of locations.

(757) 668-8931

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