Starting from January 21, Prairie Lakes Healthcare System (PLHS) will enforce a new policy requiring patients to settle co-pays, deductibles, and co-insurance at the time of service. This initiative aims to enhance patient understanding of their insurance benefits and financial obligations concerning healthcare services. Introduced in phases since April 2023, this policy now fully aligns with industry standards. The changes apply to various departments including specialty clinics, cancer centers, ENT clinics, and hospital services, ensuring transparency and consistency in billing practices.
The updated payment requirements reflect an effort to streamline financial transactions within PLHS. For clinic visits, patients must pay co-pays according to their specific insurance plans. In cases where patients opt for private payments, they are required to provide either a deposit or partial payment upfront. Hospital services necessitate that patients cover deductibles and co-insurance based on their insurance coverage. Additionally, private pay patients need to contribute a percentage of the estimated cost prior to receiving treatment. Emergency medical care remains subject to federal regulations under the Emergency Medical Treatment and Labor Act (EMTALA).
Furthermore, PLHS emphasizes the importance of patients familiarizing themselves with their insurance policies to avoid any confusion regarding coverage for office visits and medical services. Medicare patients should note that PLHS employs provider-based billing, also referred to as hospital-based billing, which may affect how their services are invoiced. To assist patients in navigating these changes, dedicated account specialists are available to address any inquiries related to the new payment policy.
In light of these adjustments, PLHS encourages open communication between patients and their insurers to ensure clarity on financial responsibilities. By implementing this immediate payment policy, PLHS seeks to foster greater awareness among patients about their healthcare costs and promote a more transparent billing process. This move underscores the organization's commitment to improving patient education and enhancing overall service quality.