Billing and Insurance

Billing and Insurance Overview

At Prairie Lakes Healthcare System, we're here to serve you before, during, and after your hospitalization, clinic visit, or outpatient procedure. We are committed to providing you with the best possible healthcare, including convenient and reliable billing services.

As an independent organization, Prairie Lakes Healthcare System accepts most insurances. When you receive your bill, please keep in mind that you may receive separate bills from the hospital, the Specialty Clinic, Prairie Lakes Brown Clinic, and other healthcare professionals involved in your care. Common partners that bill separately include surgeons from other facilities, anesthesiologists, pathologists, and radiologists. 

Our Billing Process:

  1. We submit the charges to the patient's insurance company and/or Medicare.
  2. A notification of pending charges is sent to the patient from their insurance company shortly after discharge.
  3. When we receive payment or denial of coverage from the insurance company, we calculate and send the patient their balance due.
  4. Patients will receive a text and/or email with a link to the payment portal. The link will automatically populate their account number so they will only have to enter their date of birth to authenticate into the portal.
    • Patients can make payments, set up a payment plan, view/print their statement, and set their delivery preferences from the payment portal.
  5. If the patient does not engage with the digital communication within a week, a statement will be mailed to the patient.

Time of Service Payments

Co-pay, deductible, and co-insurance are due at time of service.

  • The co-pay for your clinic visit (Specialty Clinic, Cancer Center, ENT Clinic, Primary Care Clinics) is based on your insurance plan.
  • The private pay co-pay for your clinic visit (Specialty Clinic, Cancer Center, ENT Clinic) is $200.
  • For Hospital services, deductible and co-insurance are based on your insurance plan, or a percentage of your estimate is required for Private Pay.
  • Patients who present for emergency medical care are subject to Emergency Medical Treatment and Labor Act (EMTALA) regulations.

Please contact your insurance company to find out how your office visit and medical services will be covered.

Patients may be expected to pay a portion of their bill at time of service. If you have questions regarding time-of-service payments, please call a Prairie Lakes Patient Account Specialist:

Frequently Asked Questions

Should I bring my insurance card with me to the hospital?
Yes. Insurance information is collected during the registration process. Prairie Lakes Healthcare System accepts most insurance plans.

Will you bill my insurance company?
Yes, Prairie Lakes Healthcare System will bill your insurance company or companies for you. It is your responsibility, however, to provide any requested information the insurance company needs in regard to your hospitalization. Prairie Lakes Healthcare System will also file Worker's Compensation claims.

How do I know if my insurance company will cover the charges?
It is best to check with your insurance representative prior to your hospitalization/outpatient procedure. Coverage varies with each insurance company. Coverage also varies on specific services, including those performed by anesthesiologists, radiologists, and pathologists.

How will I know if my insurance company has covered the charges?
Depending on your insurance company, you may receive an explanation of benefits in the mail. Prairie Lakes Healthcare System will also send you a statement if there is a balance due.

I have Medicare. I am confused about how prescriptions are paid for.
Generally, prescription and over-the-counter drugs you get in an observation or outpatient setting (like an emergency department), are not covered by Medicare Part B. If you have Medicare prescription drug coverage (Part D), these prescriptions may be covered under certain circumstances. You’ll likely need to pay out-of-pocket for these prescriptions and submit a claim to your prescription drug plan for a refund. Call your prescription drug plan for more information.

How can I pay my account balance?
Prairie Lakes accepts cash, checks, money orders, and credit card payments. Online Bill Pay is available through the Patient Portal. Click here to learn more about the Patient Portal.

Online Bill Pay

Who can I talk to at Prairie Lakes about my bill?
For additional information or questions regarding billing and insurance, please call:

  • Prairie Lakes Hospital & Specialty Clinic Bill: 605-882-7887 or 1-800-298-6638 | 8:00 am - 4:30 pm | Monday - Friday 
  • Prairie Lakes Brown Clinic Bill: 605-886-8482 | 8:00 am - 5:00 pm | Monday - Friday