Resources

Insurance Information

Dec 02, 2020

PrairieCare works closely with patients, their families, agency representatives, insurance companies, EAPs and managed care providers to determine all possible payment options. We are an in-network provider for most major insurance companies and managed care plans. Please call your insurance company for specific mental health plan details regarding coverage, deductible and coinsurance. Other billing questions may be answered by calling our Patient Accounts team at 952-826-8460It is ultimately the insurance member’s responsibility to verify insurance benefits.

 

In-network plans for Partial Hospital and Inpatient care:

  • Cigna
  • HealthPartners
  • Medicaid/Medical Assistance
  • MN BCBS
  • Medica/Optum Health
  • Preferred One

 

Common in-network plans for Clinic and Intensive Outpatient Programs:

  • Aetna
  • Cigna
  • HealthPartners
  • Humana
  • Medica/Optum Health
  • Medicaid/Medical Assistance
  • Medicare*
  • MN BCBS
  • Preferred One
  • Select Care

*Medicare does not have a benefit for Intensive Outpatient Programs

 

FAQ’s – Insurance

Why are there two accounts?

As a patient in our programs or hospital, you will have two accounts for which you will receive two separate statements.

  • “Professional fees” are billed through PrairieCare Medical Group. These fees are for the time spent with the clinician individually and in groups
  • Daily “facility fees” are billed through PrairieCare and cover the time spent in the program itself.

Do you have financial assistance available?

Yes, we do!   If you qualify, you or your family may receive a discount of up to 50% of your self-pay or patient responsibility balance.  (Qualification is based on the current years’ Federal Poverty Guidelines). CLICK HERE for Financial Assistance Application.

Can I get billing information about my spouse or adult children?

In accordance with Federal HIPAA Guidelines and 42 CFR and in order to protect the privacy of our patients, a signed release of information is required to share specific information about our patients aged 16 years and older, regardless of relationship.

Can I set up a payment plan?

Yes! You can set up a payment plan for up to 9 months. Larger amounts that may require a longer payback time are approved on a case by case basis. We charge no late fees and no interest will accrue on open balances.

How can I find out the specific benefits for my insurance plan?

We cannot quote benefits. For benefit information, it is your responsibility to contact the customer service number on the back of your insurance card.

How can I advocate for necessary mental health care with my insurance plan?

Many insurance companies will require pre-authorization for initial and ongoing coverage for some mental health services. It is important to understand that the insurance companies decision on pre-authorization may be independent of whether or not the services are deemed medically necessary by the provider. In other words, a provider may deem a treatment beneficial or even necessary but the insurance company may disagree and not provide payment coverage. In these cases, we encourage members to contact their insurance company and exercise their rights as a consumer to advocate otherwise.
Click here for more information on advocating for medical coverage.

Does insurance cover the Mental Health Screen?

The Mental Health Screening is offered free of cost. No charges will be billed to you or your insurance for this service.

How can I make my payments to you?

Easy, just click here for payment options!

Will Medicaid/Medical Assistance Pay for Services at PrairieCare?

Many of our services are covered under Medicaid/Medical Assistance plans.  Please call your insurance company for confirmation.

 

PrairieCare Hospital Charges

MHA Facility Fee Disclosure Guidelines (6.10.19)

Price Estimator Tool

Financial Assistance Application

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