Health Care Costs
Thank you for choosing Coteau des Prairies for your health care needs.
Our goal is to put patients first. Along with top quality care, that also
means helping you understand what you are financially responsible for
as early as possible. Information listed is effective as of January 1,
2021 and is subject to change. Inpatient charges may vary due to a variety
of reasons including, but limited to, medical complications. If you would
like to discuss price estimates, you may call our billing representative
at 605-698-7647.
Download Consumer Price List
Download Charge Master
What is pricing transparency in healthcare?
Price transparency in health care, should provide readily available information
on the price of health care services that, together with other information,
helps define the value of those services and enables patients and other
care purchasers to identify, compare, and choose providers that offer
the desired level of value. This projected estimate will help you plan
for upcoming health services. The estimate will reflect your current benefit
level as provided by your insurance company at the time of the request.
The estimate for uninsured patients reflects the hospital’s discounts
for uninsured patients. You may also qualify for Financial Assistance
by completing the forms to determine eligibility.
Know what your healthcare costs
When you have the opportunity to shop for medical services, it is important
to contact your own insurance carrier to understand which costs will be
covered and which will be your responsibility. Coteau des Prairies has
established a process to help figure out what the anticipated visit or
procedure would cost.
Are there discounts available for services performed?
When you are inquiring about discounts, Coteau des Prairies offers a 10%
discount on services/balances as is printed on monthly billing statements.
Please contact the business office to receive more information on how
this policy is set up to assist our patients.
How is this estimate amount determined?
The service you request an estimate for, will be compared to your insurance
benefits as of the date of the request. The estimate will consider co-pays,
coinsurance and deductible amounts based on your individual plan benefits
provided by your insurer.
How do I know if this estimate is correct?
Your estimated cost is a good faith estimate based on the information provided
at the time of your request. The insurance information you provide serves
as the basis for the estimate. The procedure you selected may differ from
the actual services ordered or performed by your health care provider.
This estimate covers the standard elements included with your particular
service. Any additional necessary services as determined by your health
care provider at the time of service will not be included in your estimate.
Disclaimer:
The information provided is a hospital estimate and is not a guarantee
of final billed charges. Final billed charges may vary from hospital estimates
for many reasons, among them are the patient's medical condition,
unknown circumstances or complications, final diagnosis and recommended
treatment ordered by the physician. Professional fees, such as physician,
radiologist, anesthesiologist and pathologist fees are not included in
this estimate. Insurance benefit information (where applicable) is based
on information provided by your insurance company as of the date of this
estimate. Benefits and eligibility are subject to change and are not a
guarantee of payment.
Does my insurance plan cover the service?
Before having the service performed, please contact your insurance company
to confirm coverage under your plan and that Coteau des Prairies is a
participating provider. Coteau des Prairies participates in several major
insurance and benefit plans. After you have the service, your insurance
company will review your claim to determine if your benefit plan covers
the service. Any service not covered under your plan, will be billed to you.
Does this estimate show the final amount for the service?
The actual amounts for the service may change based upon: any changes to
your care at the time of the service, treatment or services that your
health care provider determines you require during the visit, and other
information provided by your insurer. This estimate is only for your out-of-pocket
cost for services at Coteau des Prairies Healthcare System. Additional
services that may not be part of your estimate include, but are not limited
to, the length of the procedure, professional fees, anesthesia services,
pathology, and radiology technician charges. You may receive additional
bills for services ordered.
What about my privacy?
This estimate may contain private information that is legally protected.
It us only for you to use. If you are not the patient, you need to know
that sharing, copying and/or acting on this information is protected by
both federal and state laws.
Definitions
Your Insurance Allowable Amount: The estimated rate your insurance company has agreed to pay for each service
provided.
Your Insurance Co-Pay Amount: The amount which your insurance company expects you to pay upon each visit.
Your Insurance Deductible Amount: The amount you have to pay each year before your plan starts paying benefits.
Your Co-Insurance Amount: The percentage of the amount covered that your insurance requires you to pay.
Your Estimated Cost: The estimated amount you will be responsible for paying.
Insurance Plans Accepted
Hospital bills and health insurance claims can be confusing. We want to
help you understand how we bill patients, and get information on financial
assistance if you are unable to pay. You may also qualify for Financial
Assistance by completing the forms to determine eligibility. Below are
some common questions about the estimated cost of service.
Billing & Insurance
Hospital bills and health insurance claims can be confusing. We want to
help you understand how we bill patients, and get information on financial
assistance if you are unable to pay.
Fully Understand Your Insurance Benefits
To receive full insurance benefits, some health plans require you to go
to an "in-network" or "participating provider" doctor
or hospital. Call your insurance company to make sure of its conditions.
Be sure Coteau des Prairies Hospital or Doctor are in its network.
In an emergency, go to the nearest hospital. Your insurance company may
either cover these costs or ask that you go to an "in-network"
hospital if it is safe to do so.
If you choose to go to an "out-of-network" hospital in a non-emergency,
you may have to pay a larger deductible or a greater part of your bill.
Be sure to know the "out-of-network" rules of your insurance plan.
Some insurance plans require you to call for approval before you receive
certain services, or to tell the plan within a certain time after you
are hospitalized. Be sure you know your insurance company's coverage
requirements. On elective procedures, always ask both your physician's
office and your insurance plan about coverage.
Obtain any required prior authorizations, submit referral or claims forms,
and complete a coordination of benefits when needed. We will assist with
pre-authorization for procedures, tests, etc., however it is the patient’s
responsibility to make sure that insurance has approved the procedure.
Medicare
Coteau des Prairies Health Care System accepts assignment on Medicare claims.
We will complete and file your Medicare claims for you. You will receive
an explanation of benefits from Medicare stating what has been paid. Remaining
amounts will either be paid by your Medicare supplement, or become your
responsibility. At the time of registration, inform Coteau des Prairies
staff of any Medicare supplement policies that you have, or other coverage.
Coteau des Prairies has adopted policies and procedures to align with Medicare's
regulations on hospitalization. This means that upon admission or in the
event of extended hospital stays, patients may be issued a denial of coverage
if their condition does not meet Medicare approved criteria for hospitalization.
It this occurs, Coteau des Prairies staff will work with patients and
families to find other resources to provide the appropriate level of care.
Medicaid
Medical Assistance Programs, often referred to as Medicaid, may be administered
by your state or county. If you qualify for these programs it is your
responsibility to let our business office know immediately. Evidence of
eligibility must be provided on the day of your visit. Medicaid claims
must be processed within six months from the date of service. Without
this information from you, we are unable to process your claim and will
bill you personally.
When You Register at the Clinic or Hospital
Give complete information when you register at the hospital or clinic,
including driver’s license and photo ID, all insurance cards and
authorization forms.
At registration, you will be informed about how we use your health information
to submit your insurance claim.
After You Receive Services
Coteau des Prairies will bill your insurance company, Medicare or Medicaid
on your behalf for payment of medical services. Coteau des Prairies will
bill additional insurance payers if you have more than one.
Medicare or your insurance company will send you an "explanation of
benefits" that shows information about what is paid, any non-covered,
deductible or denied amounts and the balance owed by you.
You will receive regular, easy-to-read statements. These statements show
the most current balance owed by your insurance company or due from you.
After your insurance pays, Coteau des Prairies will send you a statement
to notify you of your balance owed.
Respond promptly to requests you receive from your insurance company. Sometimes,
an insurance company needs a response from you to resolve issues related
to your account or coverage. The balance owed will become your responsibility
if your insurance company:
Does not make payment within a reasonable period of time (usually 60 days
after billing)
Does not respond to our attempts to resolve payment matters on your behalf
Your Hospital Bill
Your bill shows the charges for all of the services you receive during
your stay. Charges fall into two categories:
Basic daily rate. This includes your room, meals, nursing care and housekeeping.
Charges for special services. These include items or tests that your physician
orders for you such as X-rays or laboratory tests.
Please note: Professional fees, such as physician, radiologist, anesthesiologist
and pathologist fees are not included in your estimate. Your final bill
may differ because of this.
Coteau des Prairies is only able to show pricing for our hospital; we do
not have pricing for hospitals outside of Coteau des Prairies.
Your Separate Physician Bill
You may receive bills from physicians or specialists who diagnose and interpret
tests and treatments you receive while in the hospital. Often you do not
see these specialists in person. They include pathologists, radiologists,
anesthesiologists, and other providers that see patients in our Clinic/Facility,
but do their own billing. If you have questions about these bills, call
the number printed on the statement you receive from them.
Payments
Please make timely payments on your portion of the bill. Payment for your
hospital bill is ultimately your responsibility. (Exceptions: approved
Medicare, Medicaid, TRICARE and HMO services) At the time of service or
discharge, you may be asked to pay deductibles, co-payments or other self-pay
amounts due. You may be asked to pay if you do not have insurance coverage
for your hospital services. Coteau des Prairies accepts cash, personal
checks, debit cards, money orders and certain credit cards. Interest-free
extended payment options are available to those who qualify.
Questions?
The best number to call for questions is the number on your bill. Your
physician may order tests or procedures that your insurance company does
not cover. In these cases, check your health plan handbook or call the
telephone number on your insurance card for more information.
Business office or billing staff can help you with payment issues and questions about:
Insurance benefits
Hospital charges
Payment options
Application for financial assistance programs
Language translation if needed
Financial Assistance
Coteau des Prairies billing and business office staff can answer many of
your questions. If you need help understanding your medical bills, please
call the number on your statement.