Northwest Iowa Bone, Joint & Sports Surgeons

About

NWIA Bone, Joint & Sports Surgeons, a department of Spencer Hospital, offers  specialized care in orthopedic surgery, total joint replacement, sports medicine, arthroscopic surgery, hand surgery, foot surgery, and fracture treatment.

NWIA Bone features the most experienced orthopedic surgeons in Northwest Iowa, working with the most advanced technology. Our highly educated and exceptionally skilled physicians believe in providing patients with care that help them live life to the fullest utilizing our array of services offered to best help everyone in your family. 

Orthopedic Surgeons:

Dr. Jason Hough
Dr. John Leupold
Dr. Andrew Pick
Dr. Christopher Rierson
Dr. Michael Dirkx

Learn more about orthopedic procedures performed at Spencer Hospital here: Spencer Hospital Orthopedics

Podiatric Surgeons:

Dr. Tim Blankers, Podiatric Surgeon
 

Learn more about podiatry procedures performed in Spencer Hospital's Surgery Center here: Spencer Hospital Podiatry

Learn more about NWIA Bone, Joint & Sports Surgeons here: NWIA Bone, Joint & Sports Surgeons website

Provider Based Billing

What is a provider-based clinic?

“Provider-Based” refers to services provided in an outpatient clinic that is considered a department of a hospital, as services are clinically integrated into a hospital. The clinical integration provides opportunities for enhanced coordination of patient care.

What is provider-based billing?

“Provider-Based” status is a Medicare status for hospitals and clinics that meet specific Medicare regulations and requires that Medicare, and other qualifying insurance types, be billed in two parts – one bill for the physician’s service, and another bill for the hospital/facility resources and services. This means that you may receive a bill from the clinic and a separate bill from the hospital.

Your bill depends on your specific insurance coverage. Some patients may have to pay a higher cost because of the required separate billing for physician services and for facility and resources. The increase in cost is a result of the health plan’s coinsurance and deductible. Depending on the services being provided, patients may incur additional out-of-pocket costs, especially when a deductible has not been met.  However, patients with supplement insurance coverage may not incur any additional costs.

Will my appointment be different?

Your clinical care will not change. You will continue to see your regular doctor and health care team, and continue to receive excellent-quality care. Scheduling appointments and tests will be handled as they have been in the past. At every visit, Medicare patients will be asked to complete “Medicare Secondary Payer” questionnaire containing 10 to 15 questions. While this may seem repetitive, it helps your healthcare team make sure your care is being billed in accordance with federal regulations.

Are all patients being billed this way?

No. The requirement for breaking out charges for each office visit was set by the Centers of Medicare and Medicaid. Thus, patients with Medicare, Medicare Advantage and Tricare insurance are billed using provider-based billing. At this time, commercial insurance companies do not require this breakout.  

Which local clinics are considered provider-based clinics?

Currently, both Northwest Iowa Bone, Joint & Sports Surgeons and Avera Medical Group Spencer are provider-based clinics, as departments of Spencer Hospital. For more information on your provider-based bill, please contact Spencer Hospital’s Patient Accounts department at (712) 264-6124.