Angie: Happy to chat more. In some hospital -based locations, we bill commercial payors differently than we do government payors. For government payors, we continue to bill the facility fee and POS 19/22 for services. However, for commercial, we may bill only on the 1500 with POS 11 and then the physician practice (which is also partially owned by our healthcare system) pays on a quarterly basis for the overhead services to the hospital based on a predetermined formula.
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Lisa Martin
Chief Compliance Officer
Indiana University Health
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Original Message:
Sent: 04-01-2025 12:34:32 PM
From: Angie Taake
Subject: hospital based clinic
Consider the following scenario/arrangement:
A hospital-based clinic leases a group of physicians from a medical practice to staff its clinic. The hospital provides everything typically included in the Practice Expense RVU – space, clinical and administrative staff, medical and office equipment, etc. It has been proposed that the physician group bill the "global service" under POS 11, Physician Office, and remit part of its collections back to the hospital instead of typical leasing agreements for space, staff, etc. It has been opined that this remit may satisfy the PE portion. Have any of you heard of this or have experience with this?
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Angie Taake
Compliance Educator
Washington University in St. Louis School of Medicine
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