Facts about hospital-based clinics
Many insurance plans pay for health care services provided in a hospital-based clinic differently than those provided in a doctor’s office or freestanding clinic. Your insurance may require that you meet your annual deductible and/or require that you pay a percentage of the bill rather than just an office visit co-payment. You should check with your insurance company if you have any questions. Most Hennepin Healthcare clinics are considered hospital-based clinics by the Centers for Medicare and Medicaid Services (CMS). This designation means that your billing statement will be divided into two separate charges for services provided in the clinic, including:
- A facility fee from the hospital
- A provider fee for his or her professional services
Frequently Asked Questions
A hospital-based clinic is a clinic that is owned and operated by a hospital. It is common for large, integrated
health care systems like Hennepin Healthcare, where the hospital owns or leases space and employs support personnel
involved in patient care, to operate hospital-based clinics.
All Hennepin Healthcare clinics except for Golden Valley Clinic, St. Anthony Village Clinic, Richfield Clinic, North
Loop Clinic, and the Be Well Clinic are hospital-based clinics.
When you receive care you may see charges related to the facility fee(s), including the cost of nursing staff,
supplies, equipment, and building expenses, and the other represents the provider-related fees.
Each patient’s insurance plan is unique to that patient and contracted provider. Your insurance plan may
cover the services differently for a hospital-based clinic, which could impact what you pay out of pocket. Some
insurance companies may cover both the facility fee and provider fee and some may not. If not, all or some of
the facility portion may be your responsibility. We recommend that you review your insurance benefits or
contact your insurance provider to determine what your policy will pay and whether you will need to pay
additional out-of-pocket expenses, such as deductibles or coinsurance payments.
Making informed healthcare purchasing decisions is important. Ask whether they cover facility charges in a
“Hospital-Based Outpatient” or “Provider-Based” location. If they do, ask how much of the charge is covered or
will be applied to your deductible. Also verify your co-pay responsibilities for the type of visit.
If you have questions about your bill, please contact Customer Service at 612-873-3073.