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Billing, Insurance Benefits and Coverage

How We Bill

If you see a provider at a Gillette location in the Twin Cities, your visit will be billed as an “outpatient hospital facilities” appointment rather than an “outpatient clinic” appointment.

Insurance providers treat outpatient hospital facilities differently from outpatient clinics. Depending on your health insurance, you may be charged a separate facility fee, which could result in a higher expense. You might have to make a larger copayment, pay a larger amount as a deductible or pay a larger percentage of the cost of care than you would at a clinic that isn’t affiliated with a hospital.

To discuss how this will affect you, please contact a Gillette financial advocate at 651-325-2235.

Insurance Benefits and Coverage

If you can, check with your insurance provider before your first visit to Gillette. In an emergency, that might not be possible—but be sure to contact your insurance provider as soon as you can.

Many insurance providers require you to get prior authorization before you receive a particular service. You might also need a referral or physician’s order from your primary care provider before your insurance will pay for care at Gillette. And at Gillette, we might need up to three days to process a referral or physician’s order.

Keep in mind that different insurance providers cover services in different ways. Some might not cover all of the services we offer. If your insurance provider denies your request for care at Gillette, call a Gillette financial advocate. We can help you appeal.

What to Ask Your Insurance Provider

Ask your insurance company about the details of your benefits and coverage. If you need help, ask a Gillette financial advocate for guidance.

Some questions to ask include:

  • Are the providers I’m going to see at Gillette in my insurance network?
  • Do I need a referral or a physician’s order to go to Gillette?
  • If so, how do I obtain a referral or physician’s order properly, so that my insurance covers care at Gillette?
  • What is my deductible?
  • What is my copayment for each visit to Gillette?
  • Will my copayment change if my Gillette visits are “outpatient hospital facilities” visits? If so, by how much?
  • What percentage of care at Gillette (after deductible and copayments) will my insurance cover?
  • What will be my financial responsibility—that is, how much will I be expected to pay—if I go to Gillette?
  • If my child needs a cranial orthosis, will that be considered cosmetic or medical care?
  • If my request to receive services at Gillette is denied, how do I appeal?

Make Sure Gillette Has Your Insurance Information

If you have health insurance or Medical Assistance, please give us that information before you come to Gillette.

When you make your appointment, and when you arrive at our hospital and clinics, we’ll ask you for:

  • Your insurance card(s) and/or Medical Assistance card, if any.
  • The patient’s date of birth.
  • Any other information we’ve asked you to bring that relates to your referral or insurance (if applicable).

If you have insurance but don’t have your card(s) with you, we’ll ask for:

  • The name and telephone number of your insurer(s).
  • Any group or identification numbers associated with your insurance coverage.
  • The name of the policyholder.

There are other things you can do to prepare for your Gillette visit.