Hospital Outpatient Departments

Find a Doctor

What is a hospital outpatient department?

Hospital outpatient department practices (HOPDs) are considered departments of a hospital entity, even if the practice is in an offsite location. Because the hospital licenses these practices and employs the staff involved in patient care, they are designated as hospital outpatient departments under federal guidelines.

Main Line Health is focused on meeting the evolving health needs of our communities while delivering safe, high-quality, equitable and affordable care to our patients. Hospital outpatient departments will be better positioned to:

  • Manage complex care, including advanced medication therapies
  • Ensure long-term access to essential services

While your care team and location will stay the same, the services we offer and the way we bill for services may be different.

Patient billing

Hospital outpatient departments are held to high standards of care and are required to meet federal accreditation standards. When you receive care at a hospital outpatient department, you are billed as if you were seen in the hospital itself.

You can expect to receive a consolidated patient statement that will outline any patient financial responsibility for services rendered for all Main Line Health entities, outpatient locations and Main Line HealthCare Physicians once your services have been rendered and processed through your insurer. This means that both physician charges and hospitals charges will appear on the same bill issued to you. Any physician-ordered services such as laboratory tests, x-rays, MRIs, CTs, imaging scans or other diagnostic procedures will be billable by the hospital and will also appear on this consolidated patient statement.

Professional services for which you will continue to receive separate billings include emergency department, radiology, anesthesia and pathology services. Any services provided by an independent physician will be billed separately by the independent provider.

Insurance

Depending on your health insurance plan, your total out-of-pocket costs (such as co-pays, deductibles and co-insurance) may change for services received at these locations.

Because your coverage for various hospital and physician services is dependent on your specific insurance plan, we encourage you to check with your insurance carrier prior to initiating any treatment or scheduling services to understand your coverage limits.

Medicare patients may be responsible for a coinsurance charge at a hospital outpatient department that they would not incur at another location. Main Line Health is committed to helping you make informed decisions about your care and offers financial counselors and financial assistance.

For questions regarding hospital outpatient departments, please call Main Line Health patient billing customer service at 484.337.1970, Option 3.

Frequently asked questions

What are hospital outpatient departments?

Hospital outpatient department practices (HOPDs) are considered departments of a hospital entity, even if the practice is in an offsite location. Because the hospital licenses these practices and employs the staff involved in patient care, they are designated as hospital outpatient departments under federal guidelines.

Will this affect my care or providers?

No, you will continue to receive the high-quality care that Main Line Health provides to all patients. You will see the same doctors, nurses and staff in the office and there is no need to do anything differently when coming to your appointments.

Do I need to do anything differently when I come to my appointments?

No. You will continue to schedule and attend appointments the same way you always have. The care experience will remain the same — only the billing structure may change

What are the Main Line HealthCare hospital outpatient department locations?

Beginning June 2, the following practices and locations will be considered hospital outpatient departments (HOPD) of Lankenau Medical Center:

  • Main Line HealthCare Endocrinology – Exton Square
  • Main Line HealthCare Gastroenterology – Lankenau Medical Center
  • Main Line HealthCare Hematology Oncology – Collegeville
  • Main Line HealthCare Hematology Oncology – Exton Square
  • Main Line HealthCare Hematology Oncology – Paoli
  • Main Line HealthCare Neurology – Exton Square
  • Main Line HealthCare Neurology – Paoli
  • Main Line HealthCare Neurology – Wynnewood
  • Main Line HealthCare Pain Management – Paoli
  • Main Line HealthCare Rheumatology – Lankenau Medical Center
  • Main Line Health – Jefferson Neurosurgery – Lankenau Medical Center
  • Lankenau Medical Center Infusion – Riddle (previously Riddle Hospital Infusion Center)

HOPDs have become a common model of practice for health systems locally and around the country. Becoming an HOPD allows us to better manage complex treatments, including medication therapies, and ensures we can maintain access to these critical services for our patients.

 

How will I know if a location is a hospital outpatient department?

Hospital outpatient departments are designated on Main Line Health’s web site and signs are posted in each location.

Why would I receive two bills for one visit?

Hospital outpatient departments are regulated differently than private physician offices. When you receive care at a hospital outpatient department, we are required to bill your insurer as if you were seen in the hospital itself. Because of this status, services provided are billed separately:

  • The professional fee covers your provider's time, expertise and medical care.
  • The facility fee reflects the costs of the hospital's support, including equipment, staff and other resources necessary to provide care.

Will I pay more at a hospital outpatient department?

It is possible that you may pay more for care at a hospital outpatient department than another location. We encourage you to review your health benefits or contact your insurance provider to determine what your policy covers and what out-of-pocket expenses you may incur.

These changes will only affect the billing process for patients with traditional Medicare, Medicaid, Medicare Advantage or Medicaid Managed Care Organizations (MCOs) because they have specific billing requirements for the hospital setting. At this time, patients with commercial insurance (employer-offered insurance plans) will not be impacted by this conversion.

For most Medicare patients, the additional facility charge copay and deductible may add about $25 in out-of-pocket costs. However, the exact cost will vary depending upon services rendered and patients' supplemental insurance coverage. Medicare patients will also incur a coinsurance cost to the hospital for these services. Coinsurance and deductibles are generally covered by secondary insurance with Medicare./p>

How will this affect my bill?

Because these practices are becoming hospital outpatient departments, you may receive two separate bills for a single visit:

  • One bill for professional services (provider’s time)
  • One bill for hospital-based services (facility charge)

You can expect to receive a consolidated patient statement that will outline any patient financial responsibility for services rendered for all Main Line Health entities, outpatient locations and Main Line HealthCare physicians once your services have been rendered and processed through your insurer. This means that both physician charges and hospital charges will appear on the same bill issued to you. Any physician-ordered services such as laboratory tests, x-rays, MRIs, CTs, imaging scans or other diagnostic procedures will be billable by the hospital and will also appear on this consolidated patient statement.

Professional services for which you will continue to receive separate billings include emergency department, radiology, anesthesia and pathology services. Any services provided by an independent physician will be billed separately by the independent provider.

Could this increase my out-of-pocket costs?

Possibly. Depending on your health insurance plan, your total out-of-pocket costs (such as co-pays, deductibles and co-insurance) may change for services received at these locations. We encourage you to check with your insurance company to understand how this may affect your specific coverage.

For most Medicare patients, the additional facility charge copay and deductible may add about $25 in out-of-pocket costs. However, the exact cost will vary depending upon services rendered and patients’ supplemental insurance coverage.

Medicare patients will also incur a coinsurance cost to the hospital for these services. Coinsurance and deductibles are generally covered by secondary insurance with Medicare.

Will my insurance still be accepted?

Main Line Health continues to work with a wide range of insurance plans. However, because individual plans vary, we encourage you to contact your insurance company directly to confirm how services at an HOPD are covered.

What if I cannot afford the new costs? Is financial assistance available?

Yes, Main Line Health offers financial assistance counseling and programs for eligible patients. If you are concerned about costs or have questions about your bill, please contact us at 484-337-1970, Option 3, to discuss options and resources that may be available to you.

What if I have difficulty paying for healthcare services?

Main Line Health offers financial counselors and financial assistance to assist patients with making informed healthcare choices.

Where can I get more information or ask questions about care at a hospital outpatient department?

We encourage you to contact your insurance provider to determine what your policy covers and what out-of-pocket expenses you may incur.

If you have questions about this change, how it might affect you or about your bill, please call Main Line Health patient billing customer service at 484.337.1970, Option 3. Our team is here to support you and answer any questions you may have.