Billing, Insurance and Financial Assistance

HRMC accepts most major health plans. HRMC will file all insurance claims (with the exception of out of state Medicaid plans not enrolled in and liability insurance) once the patient has provided the necessary information. HRMC has signed preferred provider contracts and therefore considered in network with the following carriers. If you don’t see your health plan listed below, please contact your plan administrator about adding HRMC as a covered provider.

• America’s PPO
• Avera Health (Not including Avera Select)
• Coventry Health Care/First Health
• Dakotacare
• First Choice of the Midwest
• GEHA (Government Employees Hospital Association)
• HealthPartners
• Humana Choice Care Network
• Integrated Health Plan, Inc.
• Medica
• Everence
• Midlands Choice
• Multiplan
• Sanford Health (Not including Sanford Elite)
• SelectCare
• TLC Advantage
• United Healthcare (Not including UHC Medicare Advantage)
• Wellmark Blue Cross/Blue Shield (Not including Wellmark Advantage)

Please keep the following in mind when paying your bill:

HRMC medical staff physicians collect independently for their services, and they may not participate in the same insurance plans as HRMC.

You may receive a bill from participating providers for deductibles, copays and/or coinsurance.

Physician’s Fees

If you have certain tests, treatments or procedures in the hospital, you may receive bills from physicians you may not have seen in person. These bills are for professional services rendered by these physicians in diagnosing and interpreting test results while you were a patient. Pathologists, radiologists, cardiologists, anesthesiologists, and some other specialists perform these services and are required to submit separate bill. If you have questions about these bills, please call the number printed on the statement you receive from them.

Insurance Resources

Insurance Marketplace
The Insurance Marketplace can help if you don’t have health coverage. When you use the Marketplace, you’ll need to provide information about your household size and income to find out if you qualify for a subsidy to help pay your monthly premium for private insurance plans. You’ll also learn if you qualify for assistance with out-of-pocket costs or for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).

healthcare.gov

Medicaid
Medicaid is a federal and state-funded program that provides health coverage for people who meet certain eligibility standards. If you are eligible, Medicaid will act as your insurance company and may pay for medically necessary services. The start of medical coverage with Medicaid depends on the date the application is received by the South Dakota Department of Social Services (DSS). Medical coverage may go back 3 months prior to the month the application is received by DSS if you have unpaid medical bills and you meet eligibility requirements during this time period.

State Medicaid Enrollment Website

Medicare
Medicare is federal health insurance for people age 65 and older and under age 65 on Social Security Disability Income (SSDI). Senior Health Information and Insurance Education (SHIINE) is a federally funded program through the Administration for Community Living and administered by the South Dakota Department of Human Services Division of Long Term Services and Support. It provides free, confidential and unbiased counseling to Medicare beneficiaries in South Dakota.

Understanding Medicare – SHIINE

HRMC offers several options to help our patients manage the payment of their healthcare services. Our knowledgable business office staff can help you understand your responsibilities and offer information on options for assistance.

No Insurance

If you do not have insurance, a representative from the business office will discuss financial arrangements with you.  Someone from our team may be available to assist you in the steps to apply for Medicare, Medicaid or other government assistance programs.

Financial Assistance

HRMC will grant financial assistance for medically necessary services to individuals who supply a completed financial assistance application and meet the required criteria. This assistance is the last resort in satisfying a patient’s account and cannot be applied in lieu of governmental assistance programs. Printed applications are available in both English and Spanish and may be obtained by visiting, calling the business office at 605-353-6223, or by downloading the application.

Financial Assistance is available up to 240 days from the first billing statement sent to the guarantor. Applications are available in both English and Spanish at the HRMC Business Office (605) 353-6223, or 1-800-529-0115 (in state only), ext. 223 or www.huronregional.org.

To better understand our policy on payment, visit our Summarized Billing, Payment & Financial Asisstance Policy. Please contact us for further details regarding payment options, financial assistance or any questions regarding your hospital or clinic bill from Huron Regional Medical Center, HRMC Physicians Clinic or New Life Clinic, by calling 605-353-6339. South Dakota residents may call toll free at 800-529-0115 (ext. 6339).

When you receive emergency care or are treated by an out-of-network provider at an in-network hospital, you are protected from surprise billing or balance billing. For more information visit Your Patient Rights and Protections Against Surprise Medical Bills –  Sus Derechos y Protecciones Contra Facturas Medicas Sorpresa.

To help patients plan their finances when possible, HRMC can provide out-of-pocket estimates for planned and routine hospital services, like medical imaging, surgery and childbirth, based on their health insurance plan. The estimate gives the patient an idea of what they may expect to pay. Online estimates are available here.

Because each person’s medical needs are unique, estimates are just approximate expenses. Please call HRMC’s business office at (605) 353-6223, central scheduling at (605) 353-6334 or email costestimate@huronregional.org for more information.

You can find a list of our charges here using the Machine Readable File, however, this does not take into account insurance or discounts.