Provider Based Billing
LECOM Health Millcreek Community Hospital strives to provide our patients with information to help them make the most informed decisions possible related to their healthcare. The information contained on this page is being provided to help you better understand provider-based billing and which LECOM Health Millcreek Community Hospital clinics are provider-based billing locations.
What is a provider-based physician practice?
The Center for Medicare and Medicaid Services (CMS) permits physician office clinics to operate as “provider-based” when certain conditions are met. These physician office clinics are integrated into the hospital and are therefore permitted to bill services as a hospital outpatient department to government operated insurance plans. These charges often show up on a statement as “facility charges” which help cover the additional expenses of operating an outpatient department of a hospital compared to a free standing physician office.
Which LECOM Health Millcreek Community Hospital clinics operate as hospital outpatient departments and bill charges as a provider-based location?
Eastside Medical Center
2627 Parade Street, Erie PA 16504
(814) 452-6383
LECOM Health Specialists
5401 Peach Street, Ste. 3500, Erie, PA 16509
(814) 868-2179
LECOM Institute for Successful Aging
5535 Peach Street, 1st Floor, Erie, PA 16509
(814) 868-3488
LECOM Institute for Behavioral Health
Adult: 4740 Peach Street, Erie PA 16509
Adolescent: 537 West 18th Street, Erie, PA 16502
(814) 454-3174
LECOM Health Millcreek Surgical Specialists
5401 Peach Street, Ste. 3600, Erie, PA 16509
(814) 868-2170
LECOM Health Orthopedics and Pain Management
5401 Peach Street, Ste. 3300, Erie, PA 16509
(814) 868-7840
Plaza 18 Medical Center
537 West 18th Street, Erie, PA 16502
(814) 456-1009
Will I experience higher out of pocket costs for being seen in a provider-based billing clinic?
It is possible for a patient to have higher out of pockets costs when obtaining services from a provider-based billing clinic. Patients that do not have a secondary or supplemental payer are more likely to experience higher out of pockets costs at these locations.
Who can I call if I have more questions about Provider-Based Clinics or my bill?
The LECOM Health Customer Service Department can be reached by calling: (814) 864-4031
Who can I speak to if I need to discuss payment arrangements or payment plan?
The Millcreek Community Hospital Billing Department can be reached by calling: (814) 868-8251
Who can I speak to if I am having difficulty paying for my bills received by Millcreek Community Hospital?
The Millcreek Community Hospital Billing Department can be reached by calling: (814) 868-8251
How much can I expect to pay out of pocket for services at a provider-based clinic?
Patients who have a Medicare supplemental payer typically do not get billed out of pocket for any out of pocket expenses for Medicare covered visits at a provider-based billing department. This is never guaranteed and is subject to each patient’s specific policy and benefits. Medicare requires hospitals that bill as provider-based clinic locations to provide estimates for what services could cost a patient who has traditional Medicare and who does not have a supplemental insurance policy.
For more information on deductibles and coinsurances please see your Medicare Handbook or visit CMS.gov. If you have questions, would like additional procedure estimates, or would like a personal estimate specific to a certain service please call our financial counselors at (814) 868-7719.