Additional Specialty Clinics Transition to Hospital Outpatient Department Billing.

Last year, we shared information about Mercy’s transition of select specialty clinics to a Hospital Outpatient Department (HOD) billing model and how those changes could affect employee out-of-pocket costs. As Mercy continues implementing this billing structure across its organization, additional specialty clinics have transitioned to Hospital Outpatient Department billing.

Effective June 22, 2026, Mercy’s Gastroenterology and Rheumatology clinics transitioned to the Hospital Outpatient Department (HOD) billing model.

What This Means for Employees

The transition to Hospital Outpatient Department billing changes how certain services are billed—not the benefits provided through the Missouri State University medical plan.

When services are provided in a Hospital Outpatient Department, patients may receive separate charges for:

• The professional services provided by the physician or other healthcare provider.
• The hospital or facility services that support the visit.

Services provided at these clinics will now be billed as hospital outpatient services rather than a specialty office visit. Under the Missouri State University medical plan, this means the specialty office visit copay will no longer apply. Instead, outpatient hospital benefits will apply, which may result in higher out-of-pocket costs through your deductible and coinsurance.

Mercy has also indicated that signage will be posted at the entrances of these former clinic locations identifying them as part of the hospital outpatient department.

Understanding Your Financial Responsibility

As discussed in our previous blog, “Mercy: Your Financial Responsibility for Outpatient & Elective Care,” Mercy’s Financial Clearance Policy applies to many non-emergency outpatient services and elective procedures. Before or at the time of service, patients are expected to address their estimated financial responsibility, which may include:

• Applicable copays, deductibles, or coinsurance.
• Charges for services not covered by insurance.
• Establishing a payment plan for any remaining balance.

Mercy does not require patients to pay the full estimated balance upfront if payment arrangements have been made. The policy is intended to help patients understand their expected costs before receiving care and provide options for managing those expenses.

Because these clinics are now billed as Hospital Outpatient Departments, employees are encouraged to understand how outpatient hospital benefits apply before receiving services.

Planning Ahead

If you are scheduled to receive care at one of Mercy’s Hospital Outpatient Department locations, consider taking these steps before your appointment:

• Contact Mercy to request a cost estimate for your visit or procedure.
• Verify how your services will be billed.
• Review your medical plan’s outpatient hospital benefits so you understand your deductible and coinsurance responsibilities.
• After your claim is processed, compare your Explanation of Benefits (EOB) with your Mercy billing statement.
• If needed, discuss payment plan or financial assistance options with Mercy.

Learn More

For additional background on these billing changes and Mercy’s financial responsibility policies, please review our previous Human Resources blog posts:

• Mercy Clinic Billing Changes and Hospital Outpatient Department Transitions (June 2, 2025), which explains provider-based billing and Hospital Outpatient Department billing.
• Mercy: Your Financial Responsibility for Outpatient & Elective Care (June 24, 2025), which outlines Mercy’s Financial Clearance Policy, payment expectations, and resources available to patients planning outpatient or elective care.

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