Outpatient Charges

What are outpatient charges?

Think about health care charges like the sticker price for a car. Hospitals, surgical centers and physicians often lower their charges for health insurance companies and government programs like Medicare and Medicaid because they cover a lot of patients. These "volume" discounts may reduce full charges by 50%, 60% or even more.

Are there other charges I may be billed for?

In addition to your main bill from your doctor or the facility, you may also be billed for other professional services such as anesthesia, laboratory, other physician's professional fees and other charges. While your care may vary depending on the services you need, here are a few examples:

If you had a colonoscopy you may also receive a bill for a surgeon, a radiologist, or an anesthesiologist.
If you had a doctor's office visit, you may also receive a bill for a lab test or radiologist.
If you had knee surgery, you may also receive a bill for a surgeon, anesthesiologist, radiologists, lab tests or other services.

Why do charges vary by the type of facility?

Patients that are sicker or have more complex conditions may need to receive care in a Hospital Outpatient Department for a test or procedure in case their condition worsens. Sicker patients may also have a higher risk of complications that could possibly require inpatient admission to a hospital. Ambulatory Surgical Centers offer same day surgical care to patients in a facility that is equipped to handle emergency care. Some procedures may be performed in a Physician Office, especially when patients have a lower risk of complications. Facilities, such as hospitals, offering more advanced care may charge more due to the higher costs of maintaining a larger staff and being able to handle a wider variety of patient needs.

What if I do not have insurance or need help paying my bill?

If you do not have insurance, you may be asked to pay full charges, much like the sticker price for a car. If you pay for care yourself, your best bet for non-emergency care is to call your doctor or facility and try to negotiate lower charges ahead of time. If you cannot pay your bill, your hospital or doctor may be able to help you reduce your bill or create a payment plan. For non-emergency care, it is important to make these arrangements before you receive care. You can learn about financial assistance policies at many Virginia hospitals at http://www.vhha.com/research/financial-assistance-policies/.