The difference between provider and facility charges
Why you may get more than one bill
If you get more than one bill in the mail after a medical visit, you may wonder if you were charged twice or if something wasn't covered by your health plan. But often it’s because several people and services worked together to support your medical care and treatment.
For example, you may see a doctor at a hospital-based clinic. The doctor provides medical care, but the hospital also provides the exam room, equipment, nursing support, and other resources needed for your care.
Because these services are separate, they are often billed separately. As a result, you may receive both a provider bill for the medical services you received and a facility bill for the support services used during your visit.
What provider charges cover
Provider billing covers the care you receive from health care professionals. This can include services from
- Primary care doctors
- Specialists
- Surgeons
- Anesthesiologists
- Radiologists
- Nurse practitioners and physician assistants
Even if you never meet a doctor in person, you may still receive a bill for their work. For example, a radiologist who reviews your X-rays or imaging results may bill separately for those services.
What facility charges cover
Facility billing covers the costs of the hospital, clinic, or outpatient center where you received care. These charges may include
- Exam rooms or operating rooms
- Medical equipment
- Nursing care
- Medications given during your visit
- Medical supplies
- Other support services needed for your treatment
Think of facility billing as the cost of the place where your care happened and the resources used to provide that care.
