November 17, 2006

elevate: Answering the Tough Questions

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Medical Center leadership answers the tough questions about what the elevate program is and what it means for the people who work at VUMC.

Question: Why do we send our patients two bills instead of one?

Answer: The practice of sending inpatient hospital and emergency room bills separate from a physician bill is required by state law. Vanderbilt hospitals are required by state law to provide a detailed statement to the patient shortly after discharge. The physician is not required to do the same. These laws, and federal billing regulations, inescapably give rise to separate billing processes for physicians and for hospitals.

For outpatients receiving services in the clinics, physicians' professional fees are billed separately from technical services such as laboratory tests, radiology exams and other ancillary services. This is because our clinics are associated with our hospitals. This association leads to two bills for services received in the clinic.

Research on this issue has indicated that our patients are being billed consistent with most other facilities across the country. In most situations the patients at other inpatient facilities receive more than two bills because physician services are not provided from a single medical group such as the Vanderbilt Medical Group.

— Rick Wagers, VUMC chief financial officer