Q: Can I find out what Prairie Ridge Health charges for a medical procedure I'm planning to have?

A: If you would like to request a price for a future service, please call a Patient Financial Counselor  at (920) 623-2200 or (800) 549-7511.

In order to be able to give you the most accurate information possible, we ask that you try to obtain information from your physician about what procedure he/she is requesting be done. Your physician should be able to supply a CPT or ICD-9 procedure code. We can then look at our database, and give you a more accurate price quote.

Please note that you will be given an average cost or a price range rather than a specific estimate. The final charges are based on a variety of factors related to the clinical service provided, the diagnosis associated with those services, supplies used, etc. While it is possible to estimate these, it is not possible to precisely define these until after the service has been provided.

Q: I received care at Prairie Ridge Health and received several bills. Why don't you put all of the charges on one bill?

A: Prairie Ridge Health’s statements reflect hospital charges only.  Radiologist and Pathologists will bill separately for their services.  Should you have any question concerning their bills, please contact them directly.  If you receive a billing statement and have not visited us as a patient, this bill may be for lab specimens sent to us by your physician.

A: Each time you receive services from the hospital a separate account is created.  It is possible to have several accounts open at the same time.

Q: Will I receive an itemized statement?

A: If at any time you wish to receive an itemized statement, please call our Business Services team members at (920) 623-1423 or (877) 731-7108.

Q:  Why doesn’t my statement show my payment?

A:  Please allow 5 days for your payment to be applied to your account.  If it has been more than 5 days, please contact our Business Services team members.

Q: I a.m. covered under a HMO or PPO.  How can I find out if the provider I want to see is a participating provider under my plan?

A: There are numerous HMO and PPO plans, and provider networks associated with these plans change frequently.  Please call your insurance company to obtain this information.

Insurance FAQs

Q: Should I bring my insurance card with me to the hospital?

A: Yes, the information on your insurance card is needed for the hospital to file a claim with your insurance company or companies. When you register we will ask for information about your insurance coverage and have you sign a few forms. This registration process goes much faster when you bring your insurance information with you. All forms of health insurance must be presented at the time of registration.

Q: Will you bill my insurance company for me?

A: Yes, as a courtesy we will bill your insurance company, or companies. It is your responsibility to provide any requested information to your insurance company (accident information, claim forms, other health insurance information, or pre-existing condition information).

Q: Do I need to let my insurance company know that I'm going to be in the hospital? And what will they cover?

A: We encourage you to check with your insurance company or your employer regarding coverage. Because there are so many types of insurance plans, we do not know if you need prior approval or notification for your hospital stay. Contact your insurance company or your employer with specific questions about what is or is not covered by your insurance plan.

Q: How do I know if my insurance company will cover my visit or certain services?

A: Coverage varies with each insurance company. The hospital staff does not know whether a particular service will be covered. Medically necessary and appropriate services may not always be covered by your insurance contract. Please refer to your insurance member handbook or call your insurance company with questions.

Q: How do I know if my insurance company will cover services provided by all professionals (i.e. anesthesiologists, radiologists, and pathologists) involved with my treatment?

A: We encourage you to check with your insurance company or your employer about this. Each professional needs to contract individually with insurance companies and the hospital does not know if each professional is contracted with your insurance company.

Q: How will I know if my insurance company has paid my bill?

A: If there is a balance due from you after the insurance company has paid its portion, we will send you a statement. This statement indicates the amount that has been paid and any balance you are required to pay. This is your bill; you are required to pay this bill in full or set up payment arrangements by contacting our Business Services team members at (920) 623-1423 or (800) 731-7108.

Q: How do I follow-up with my insurance company?

A: Before you call, have available your insurance card, date of service, facility name, original billed amount, patient name and claim number if applicable. Ask for the status of the account. If paid, ask when and to whom. Write down the name of the person you talked to at the insurance company. If the bill has not been paid, find out when the anticipated payment date is, and ask what is needed. If the bill is not paid in the stated time frame, follow up with the insurance company again and, if necessary, request to speak to a supervisor.

Q:What do I do if I disagree with how much my insurance company has paid on my bill?

A: If you have questions regarding the payment call your insurance company for an explanattion of the payment. If the insurance company finds that an error was made, note the information and whom you talked to at the insurance company. Request an anticipated payment date and ask if they need anything to complete processing. If the insurance company feels the bill was paid correctly and you still disagree, find out from the insurance company what you need to do to file an "appeal" with them. Filing an appeal will not guarantee that the insurance company will pay more on your bill, but the claim will be reviewed for reconsideration.

Q: Will the hospital file my Worker's Compensation claims for me?

A: Yes, we will bill worker's compensation insurance, or the employer, for patients that provide that information.

Q: Will the hospital file my motor vehicle accident or medical liability claims for me?

A: We do not bill third party insurances (i.e. attorneys, auto insurance) except if the patient has Medicare. At the patient's request, we will provide them with an itemized statement to forward to the liability carrier. We require the patient to pay the hospital bills; PRH does not become involved in liability disputes.

Payment FAQs

Q: When do I become responsible for my bill?

A: You are legally responsible for your bill at the time you receive services from the hospital. We require all patient balances be paid immediately after you are notified.

Q: How can I pay my patient balance?

A: You may pay by cash, check or money order. Make check or money order payable to Prairie Ridge Health. Please include your account number. Mail to: Prairie Ridge Health, 1515 Park Avenue, Columbus, WI 53925, Attention: Business Services. Or you may choose to use your MasterCard, VISA, or DISCOVER Card by using our online Bill Pay Service.

Q: Do I have to pay my co-payment at the time of service?

A: Yes, you are expected to pay your estimated co-payment when services are provided.

Q: When will I receive a bill?

A: A statement will be mailed to you after your insurance has paid or within 15 days from your date of service if you are uninsured.

Medicare FAQs

Q: Why do I have to give you information about other insurance if I have Medicare coverage?

A: Medicare requires us to bill any insurance company that could have responsibility for your expenses before we bill Medicare. In fact, Medicare will not allow us to file claims until the other insurer has denied claims. In certain situations, the hospital must consider the possibility that another party may be responsible for your expenses before we bill Medicare. For example, if you were injured in a car accident, at your worksite, or on someone else's property, it is your responsibility to make sure those claims are filed appropriately.

Q: Do I have to sign any forms before Prairie Ridge Health can bill Medicare?

A: You will be asked to sign a Consent for Treatment form each time you receive services. You will also be asked questions each time you receive services which Medicare requires.

Q: I have health insurance in addition to Medicare coverage. Will you bill that insurance company also?

A: If you have given us information about your additional health insurance, we will bill that insurance company after Medicare has made their payment.

Q: What is a Medicare Explanation of Benefits form?

A: The Explanation of Benefits form is an information document that Medicare sends to you after it has processed your medical claims. The Explanation of Benefits form provides you with information about the payment status of your bill.

Q: What is the difference between Part A and Part B Explanation of Benefits forms?

A: Part A covers inpatient hospitalization and Part B covers outpatient and physician services.

Q: What should I do with the Explanation of Benefits form?

A: We recommend you keep the Explanation of Benefits forms you receive from Medicare until all your medical claims have been paid in full. If you have other health insurance in addition to Medicare coverage, your insurance company will normally require a copy of the Explanation of Benefits from you before they will pay any remaining balance on your account.

Q: Should I pay the balance that is listed as "your total responsibility" on the Explanation of Benefits form?

A: No. This amount could change depending on your individual insurance coverage. You should wait until you receive a bill from your medical provider before making payment.

Q: Will I have to pay any money for my hospital visits?

A: As a Medicare patient, you will only be responsible for non-covered charges, co-pays and deductible amounts. These amounts may vary depending on your Medicare coverage. We do not know what your payment may be until we receive the notification from Medicare. Once Medicare lets us know your responsibility, we will bill your other health insurance company (if you have coverage) for the balance. If you do not have other health insurance, you will be billed for the balance.