Understanding Your Bill

At Brookings Health System, we are committed to helping you understand your bill and resolve any billing questions you may have. As a courtesy, we submit all bills directly to your insurance company if you have provided us with your insurance information. You willbilling-services.jpg receive an initial summary of all your hospital charges and a monthly statement thereafter detailing all payments on the account until the account has a zero balance. If an insurance company fails to respond to our requests for payment, we may contact you for assistance in resolving your outstanding claim.

If you receive a bill from us you feel should be covered by your insurance company, we recommend you contact them directly and refer to your Explanation of Benefits to confirm why the claim was not paid. If you need assistance, we will be happy to work with you and your insurance provider to resolve any billing problems that might arise.

Insurance/Medicare/Medicaid Benefits

Brookings Health System will attempt to contact patients scheduled for services prior to their arrival at the hospital to verify insurance information in advance. By preregistering patients, we can greatly reduce wait times as well as the potential for billing problems. We are committed to making the registration process simple and efficient.

It is the patient’s responsibility to ensure your scheduled services will be covered by your insurance provider and all referrals and pre-authorizations have been obtained. We recommend you contact your insurance company prior to your visit to confirm the following:

  1. Is the service covered under my health insurance plan? Under what conditions is it not covered?
    You will be responsible for any services not covered by insurance.

  2. Is a referral required for this service?
    If a referral is required, your physician is responsible for sending a referral to your insurance company. 

  3. Does this service require pre-authorization to be covered?
    If prior authorization is required, it is your responsibility to ensure your physician has obtained the authorization.

  4. Does this service have to be performed by a particular provider?
    You may incur a higher co-payment or deductible or be liable for the entire cost of services performed outside of your insurance company’s network of providers. 

  5. What is my deductible or co-payment amount for this service?
    We would appreciate patient responsibility payments at the time of service, unless other arrangements have been made.

If you are unsure whether your insurance is a “Participating Provider” with Brookings Health System, please contact the Business Office at (605) 696-8030.

Physician Billing

Brookings Health System will submit a bill to you for our facility charges, diagnostic tests, and lab work performed during your visit. Some specialized lab work may need to be sent to an outside facility for testing, in which case you will receive a bill from that facility for their services. Your physician, surgeon, pathologist, and radiologist will bill you separately for their professional services. Please contact them directly with billing questions regarding their services.

Contact information for local physician groups:

Avera Medical Group - A Department of Brookings Health System
(605) 697-9500
Sanford Brookings Clinic (605) 697-1900
Physician's Laboratory Ltd. (605) 322-7200

 

 

 

 

Emergency Department Visits

Your insurance provider may require notification of your visit to the Emergency Department within a specific timeframe. Notifying your insurance provider is your responsibility. Brookings Health System only notifies insurance providers if you are admitted to the hospital. It is your responsibility to notify your physician of your Emergency Department visit.

Your insurance co-payment may be higher for Emergency Department visits than for a physician’s office visit. All services performed in the Emergency Department are considered emergency room services and will not be billed the “urgent care” or “physician” co-payment amount. Please verify the amount you may owe for this visit with your insurance provider.

You will receive a bill from Brookings Health System for your visit to the emergency department. You may also receive bills from the Avera Medical Group Brookings or other health care facilities depending on the services received. Examples include specialized lab work, which may need to be sent to an outside facility for testing, in which case you will receive a bill from that facility for their services. If a physician from Avera Medical Group Brookings provides a consultation service, you may receive a bill from that physician.

FAQs about Commercial Insurance

FAQs about Medicare and Medicaid