Definition of Provider-Based Radiation Oncology

In the health care industry, the term "provider-based" refers to a specific billing process for services provided at a clinic or hospital. Provider-based status is applied to hospitals that meet certain Medicare regulations. Provider-based radiation oncology centers are approved by Medicare.

Definitions

• Radiation oncology is a provider-based service at many hospitals and clinics.

  Oncology is the branch of medicine that deals with the treatment and study of tumors. According to UCLA Health System, if your tumor is treatable with radiation therapy, you will be referred to a radiation oncologist who will work with your primary doctor and sometimes with other specialists, like surgeons, and will oversee your care.

Effects

• If you are referred to a provider-based radiation oncology service, this will affect the billing you receive. Each patient's insurance plan is unique. Some insurance companies cover both hospital charges and provider-based radiation oncology charges, and some may not. So check with your insurance to see if these services are covered.

Medicare/Medicaid

• According to Wake Forest University Baptist Medical Center, Medicare and Medicaid patients using provider-based services may receive two bills. Medicaid patients will also pay two copays. Depending on the service provided and the hospital rules, additional expenses for Medicare and Medicaid patients may be incurred when using provider-based services.