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Provider Basing at The Kirklin Clinic of UAB Hospital

As of March 1, 2014, The Kirklin Clinic (TKC) will become an outpatient department of UAB Hospital. It is common for outpatient clinics to be a part of the hospital. Most other academic medical centers are organized this way; in fact, several of our clinics already operate as hospital outpatient clinics, including our trauma clinic and infusion center. This is referred to as "provider basing" or "hospital-based."

Here are several resources that may help answer some of your questions about what this means to you, our patient.

Hospital-Based Outpatient Patient Brochure   [Download PDF]  
Hospital-Based Outpatient Frequently Asked Questions  [Download PDF]  
Hospital-Based Outpatient Frequently Asked Questions About Billing   [Download PDF]  

We are committed to helping you understand these changes and how they will impact you.

If you have additional questions please call our customer service representatives at 205-731-6055 or 1-866-610-6055 between 8 a.m. – 5 p.m., Monday through Friday.

They can assist you over the phone or if you prefer to discuss in person, they'll be happy to schedule an appointment with a patient financial counselor.

General FAQs

Q: What does "hospital-based outpatient" or "provider-based" mean?
A: These are terms that Medicare uses to describe outpatient clinics that are actually part of a hospital. Basically, it means that physician offices at The Kirklin Clinic are now considered to be departments of UAB Hospital. It is a very common model of practice for integrated health care systems and is found in many hospitals and facilities, locally and around the nation.
 

Q: What UAB Medicine clinics will become hospital-based?
A: All clinics in The Kirklin Clinic building located on 6th Avenue South will be licensed as hospital­ based outpatient clinics. There will be no changes to operations at our Acton Road location. If you are unsure if this affects a specific clinic, please be sure to ask when scheduling your appointment.

Q: How will I know if a clinic is a hospital­ based outpatient (or provider-based) clinic?
A: Ask when scheduling your appointment. Hospital-based outpatient clinics will have signage reflecting that the clinic is a department of UAB Hospital.
 

Q: How will this affect me?
A:This change will benefit patients in several ways:

Your medical records will be better coordinated between your physicians.
The hospital and physicians will be able to better coordinate your care across the clinics and hospital. TKC will be held to even higher clinical standards to help maintain the highest patient safety and service quality guidelines.

You may notice the following changes:

Signing in may take a little bit longer at first for Medicare patients. We have a few more questions that we have to ask each patient. We appreciate your patience. You will now receive two bills instead of one, just like if you were to visit the hospital. This is a federal regulation. One bill will be for services provided by the physician and the other for the facility-related expenses.You may also receive two separate statements from your insurance carrier for outpatient clinic visits.

Q: Will there be changes to the check-in process?
A: The Centers for Medicare and Medicaid Services (CMS) require that we verify whether or not Medicare is your primary insurance at every visit.This requires an additional form be completed prior to being seen.
 

Q: Why are the clinics at The Kirklin Clinic changing to hospital-based outpatient clinics?
A: UAB Medicine is continually trying to find ways to provide the highest quality of care. The care provided at The Kirklin Clinic has always met a very high standard and will continue to participate in The Joint Commission (TJC) accreditation process, which works to improve healthcare for the public and helps organizations provide a safe and effective quality of care. However, as a hospital outpatient department, TKC will now be required to meet hospital accreditation standards, which are greater than those of a non-hospital-based outpatient clinic.

Q: What are the benefits of being cared for at a hospital-based outpatient clinic?
A: Medicare acknowledges the value of providing care in an integrated, collaborative environment. Hospital-based outpatient clinics are held to nationally recognized service and patient care standards, leading to high quality care for patients. In addition, we will be able to better coordinate your care across our facilities and your medical record will also be better consolidated making it easier for you when visiting UAB Medicine.
 

Q: Is this change part of Health Care Reform?
A: No. Health care reform and the transition of our clinics to hospital-based status are not related.
 

Billing FAQs

Q: What does "hospital-based outpatient" or "provider-based" mean?
A: These are terms that Medicare uses to describe outpatient clinics that are actually part of a hospital. Basically, it means that the physician offices at The Kirklin Clinic are now considered to be departments of UAB Hospital. It is a very common model of practice for integrated health care systems and is found in many hospitals and facilities, locally and around the nation.
 

Q: What are the benefits of being cared for at a hospital-based outpatient clinic?
A: Medicare acknowledges the value of providing care in an integrated, collaborative environment. Hospital-based outpatient clinics are held to nationally recognized service and patient care standards, leading to high quality care for patients.

Q: What UAB Medicine clinics will become hospital-based?
A: All clinics in The Kirklin Clinic building located on 6th Avenue South will be licensed as hospital-based outpatient clinics. Those located at the location on Acton Road will not be licensed as hospital-based outpatient clinics. If you are unsure, please be sure to ask when scheduling your appointment.
 

Q: How does "hospital-based" outpatient billing affect patients?
A: Patients may now receive two bills for services provided in the hospital-based clinic - one for the services provided by the physician and one for the services provided by the facility. Depending on their insurance coverage, patients may pay more for certain outpatient services and procedures. We recommend patients review their insurance benefits or contact their insurance provider to determine what their policy will pay and what out-of-pocket expenses they may incur based on the location of the services provided.
 

Q: What if the patient has secondary or supplemental insurance coverage?
A: Coinsurance and deductibles may be covered by a secondary or supplementary insurance policy. The patient should check with his/her benefits or insurance company for detailed answers related to secondary insurance.

Q: Does this change apply to patients with private insurance such as Blue Cross Blue Shield, United Healthcare, MedCost, Cigna, or Aetna?
A: Yes. All insurance payers, including commercial payers, will be billed for professional and facility charges.
 

Q: How does this affect a patient who has Medicare, Medicare Advantage, or Medicaid?
A: Medicare and Medicaid patients will receive two separate bills for services provided in the clinic - one from the physician and one from the hospital. Medicaid patients will be required to pay two co­ payments for the clinic visit- one co-payment for the physician visit and one co-payment for the hospital visit. For patients covered by Medicare or Medicare Advantage plans, non-physician charges billed by the hospital will be subject to co-insurance.
 

Q: Why do some patients need to complete a Medicare Secondary Payer (MSP) questionnaire?
A: As a participating Medicare provider, we are required to screen Medicare patients according to the MSP rules. At each visit, Medicare patients will be asked the MSP questions. These questions help us confirm if Medicare or another payer should process the insurance claim as primary.
 

Q: What can patients do if they are having difficulty paying for healthcare services?
A: Patients that are having difficulty paying for healthcare services are able to meet with the financial counseling team located at TKC. Financial counselors are located on the 2nd Floor of TKC.

Q: Do I have to make a payment before I receive services?
A: It is our policy to collect the professional charge co­ payment prior to or at the time of service. Co-payment and co-insurance amounts for facility charges will be billed to the patient once the insurance claim has been adjudicated. To discuss billing policies further, patients are able to meet with a financial counselor. Financial counseling is available at TKC to all patients at the time/prior to the scheduled appointment.
 

Q: What should patients with health insurance ask their insurance carrier if they have questions about the new billing process?
A: Patients should ask their insurance provider if facility charges are covered in an outpatient hospital clinic. To the extent that facility charges are covered, the patient should also ask about the financial responsibility associated with the services as facility charges may be applied toward the hospital deductible and/or co-insurance portion of their benefits.