Prairieville Family Hospital is committed to delivering superior medical care that saves patients both time and money. Because we are a physician-owned facility, we are in a unique position to help control your out-of-pocket expenses. We accept all private insurance plans and can offer reasonable self-pay options via cash, check or major credit card. We are unable to participate with Medicare, Medicaid, or Tricare at this time. Learn more by clicking on the topics and questions below.
We recognize that emergency medical expenses are never expected, and healthcare benefit plans can be difficult to understand and navigate. Our Patient Advocacy team is dedicated to making you feel comfortable raising questions and/or concerns about your recent visit, your insurance copay/deductible and/or your balance due with us. When you receive your bill(s), please call our Patient Advocacy Line (PAL) at 833-966-4861 for assistance.
Prairieville Family Hospital (PFH) accepts all major private insurance plans such as Aetna, Humana, United Health, Cigna and BlueCross/BlueShield. We also accept out-of-pocket (self-pay) payment in the form of cash, checks or major credit cards. Your ER co-pay will be collected at the time of your visit. We will then bill your insurance company for the policy’s emergency room benefits. There will be two different claims mailed to your insurance company: the facility bill and the physician bill. If you have any questions concerning your bill, please contact us.
PFH understands that insurance and medical billing is a confusing and overwhelming process for all of us. The system inherently limits access to accurate information about the costs and reimbursements associated with medical treatment.
Recent legislation to bring transparency to billing for healthcare services has finally been enacted. This will provide our community the opportunity to make informed decisions about costs when seeking healthcare services. Hospitals and doctors will have a better understanding of the insurance company’s average reimbursement for healthcare services in our market. Patients will finally have visibility to the pricing of the healthcare services that are provided.
PFH will continue to provide the most competitive prices in the market. These industry changes will confirm that our current business practices have resulted in patients paying much less out of pocket for healthcare services at PFH than at any other hospital in the region. We are thankful that this new legislation will bring transparency and accountability to the insurance billing process. We are in the process of updating our charge master based on these new regulatory requirements.
For all cases deemed emergent, Louisiana state law requires your insurance company to pay for your emergency care — even if the emergency room is classified as out-of-network. The state of Louisiana empowers patients to use a standard called the “prudent layperson standard” when determining what constitutes an emergency. If your insurance provider refuses to reimburse you for your emergency room visit, you may file a complaint with the Louisiana Department of Insurance (LDI). For more information about this process, visit the LDI website.
For decades, insurance companies have dictated the cost of care. Until this year, the insurance companies did not share publicly or privately what they reimburse for services. Doctors and hospitals had to blindly negotiate contracts with insurance companies without knowing the actual market value of the services being provided. As such, some doctors and hospitals chose to stay “out of network” if they have reason to believe the “in network” reimbursement is undervalued and unfair. Reimbursement is then negotiated “out of network” after services are provided. Not knowing what the insurance companies’ “allowed amounts” are, the initial charges are high so providers and facilities can negotiate a fair value for the services provided. PFH will never expect you to pay beyond your “in network” benefits and “allowed amounts.” PFH will never balance bill you for charges “not allowed” by your insurance company. In fact, PFH can offer additional savings through our Prompt Pay Program and continue to be the most affordable hospital in the surrounding market. We are in the process of updating our charge master based on these new regulatory requirements and we will continue to update it as we receive more information.
Please contact us today and we’ll be happy to help.