In your example, the hospital very likely billed the same services and charge amounts. This is standard practice. Also, captured on the claim form they submit to the payor is who rendered the services and also other modifiers/adjustments that indicate you were seen by a mid-level provider that was overseen by a physician. Regardless, what ultimately matters is the negotiated rate. As a general rule of thumb, payors reimburse mid-level providers (nurse practitioners/physician assistant/etc) at 80% of the physician equivalent reimbursement. So if a doctor gets paid $100 for a wellness check, then a PA would get $80 for a wellness check assuming everything was the same.
This all can get a little hairy / confusing as each state has different laws around what nurse practitioners and physician assistants can or can not do (which then impacts billing). Some states allow little to no oversight by a physician, where as other states it is more strict.
I have no idea about other tradeoffs (quality, access, etc) regarding the use of mid-level providers in replacement of traditionally physician services.
I think people assume that they are receiving worse service from a PA vs a MD.
A PA may have more time to research your condition. They have more experience with your particular condition.
I went to a PA recently when my usual MD was not available. They knew of a recently(ish) released test that could be helpful in the situation. I did the test, and the MD reviewed it. The MD wasn't familiar with the test, but it ended up being very important.
And they have a right to make that assumption. The important thing is making sure the patient is aware they are getting a PA and not an MD. Let the patient decide if that's OK.
That said, my experience with pa vs md hasn’t really been that different, they all just follow the same flowchart
That little scam is used by my local hospital also. If you don't ask for a specific doctor when you make an appointment you get a PA (Physician's Assistant). Then they bill the same amount as a doctor would. The justification is that the PA has access to a doctor if needed. So presumably you are getting the same level of service, since the PA can talk to the doctor if needed, so this expands his abilities to the same level as a doctor.
This practice is legal. To avoid getting a PA specifically ask for a "MD Doctor". If you don't say "MD" they will give you a PA even if you ask for a "Doctor".