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How will Avera use my health information to submit my claim?

At registration, you will be informed about how we use your health information to submit your insurance claim. (In Minnesota, we will ask your permission to release your health information to your insurance company.) Avera will bill your insurance company, Medicare or Medicaid on your behalf for payment of medical services.

What forms of payment does Avera accept?

Avera accepts cash, personal checks, debit cards, money orders and certain credit cards. Interest-free extended payment options are available to those who qualify. Questions?

Is avera a good health system?

Avera has been named among the nation’s 15 Top Health Systems. Learn about this and quality accolades earned by numerous Avera hospitals, long-term care centers and other facilities.

Will Avera assist with pre-authorization?

We will assist with pre-authorization for procedures, tests, etc., however it is the patient’s responsibility to make sure that insurance has approved the procedure. Avera locations accept assignment on Medicare claims.

What is Avera Medical Group?

Avera Medical Group Family Health Center – Dawley Farm will provide a complete community-focused medical center with a wide continuum of care for residents in eastern Sioux Falls. Our services will address the health care needs of most individuals and families – all under one roof.

When is Medicare open enrollment 2021?

Take advantage of no health questions asked for individual and family, and Medicare Supplement plans during an extended open enrollment through August 15, 2021. Consider your options and see if you qualify for payment reductions.

How to get full benefits from Avera?

To receive full insurance benefits, some health plans require you to go to an "in-network" or "participating provider" doctor or hospital. Call your insurance company to make sure of its conditions. Be sure your Avera hospital or doctor is in its network. In an emergency, go to the nearest hospital.

What does Avera do after insurance pays?

After your insurance pays, Avera will send you a statement to notify you of your balance owed. Respond promptly to requests you receive from your insurance company.

What does Medicare send you?

Medicare or your insurance company will send you an "explanation of benefits" that shows information about what is paid, any non-covered, deductible or denied amounts and the balance owed by you. You will receive regular, easy-to-read statements.

Does Avera charge for initial consultation?

Avera billing and business office staff can answer many of your questions. Avera also has financial counseling services available. There is no charge for an initial consultation, and for a nominal charge, our financial counselor will manage your medical billing file and will contact Medicare and/or your insurance company on your behalf.

Does Avera have a denial of coverage?

This means that upon admission or in the event of extended hospital stays, patients may be issued a denial of coverage if their condition does not meet Medicare approved criteria for hospitalization.

Does Avera accept Medicare?

Medicare. Avera locations accept assignment on Medicare claims. We will complete and file your Medicare claims for you. You will receive an explanation of benefits from Medicare stating what has been paid. Remaining amounts will either be paid by your Medicare supplement, or become your responsibility.