As a leader in providing psychiatric healthcare, PrairieCare provides pricing information to help patients and families better understand their costs and make well-informed decisions when selecting services.
In compliance with Centers for Medicare & Medicaid Services (CMS) Price Transparency rule that took effect on January 1, 2021, you will now be able to view a complete price list for our child and adolescent inpatient and partial hospitalization services. As a consumer you also have the ability to view the complete list of CMS Shoppable Common Services.
What You Should Know:
The charges listed do not reflect what you may personally owe for the service. This price list reflects the PrairieCare billable charge, not the owed amount or what you are required to pay. These charges are the amount billed to your insurance carrier. PrairieCare has a negotiated payment rate with a variety of different insurance carriers, and those payment rates may vary based on your specific plan. State and federal governments set payment rates for those who utilize public programs including Medicare and Medicaid.
What to Expect:
Depending on your insurance plan, your coverage may include a bundled charge comprised of professional staff service, equipment and facility charges. This may not be the case for everyone and is dependent upon the individual’s insurance plan. Other plans may not include bundled charges and you may receive two bills for services provided in our inpatient setting and/or partial hospitalization program. One bill will be from PrairieCare LLC for the hospital or partial hospital program services, and the other bill will be from St. Croix Psychiatric LLC (doing business as PrairieCare Medical Group) for the services and time provided by the physicians and other clinicians. Please contact your insurance carrier’s customer service number located on the back of your insurance card for a more comprehensive explanation of your financial responsibility.
Understanding Cost of Service:
We strongly encourage you to contact your insurance carrier to review your personal benefits in order to determine what your out of pocket costs may be. Please be reminded out of pocket cost will vary from person to person. Out of pocket costs are based on your deductible, co-insurance, copayments (if applicable) and out of pocket maximum costs allowed per patient. At PrairieCare we do our best to provide the most accurate estimate of cost based on the information listed above. Since we are unable to know how much of your personal benefits you have utilized, we are unable to provide an exact cost of service, and strongly encourage you to speak with your insurance carrier directly to best understand what your specific out of pocket cost may be.
Here to Help:
PrairieCare is available to assist with your financial services questions and needs. Please do not hesitate to call us at (952) 826-8460 to speak with one of our Patient Accounts Representatives or Financial Counselors.