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Financial Arrangement Procedure

If you have health insurance we will need a copy of your identification card.  We may also need the insurance forms which are supplied by your employer or the insurance company.  You will be asked to assign benefits from the insurance company directly to the hospital.

If you are a member of an HMO or PPO your plan my have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures.  It is your responsibility to make sure the requirements of your plan have been met.  If your plan’s requirements are not followed, you may be financially responsible for all or part of the services provided.  Some physician specialists may not participate in your healthcare plan and their services may not be covered.

If you are covered by Medicare we will need a copy of your Medicare card to verify eligibility.  You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others.  Deductibles and co-payments are also the responsibility of the patient.

If you are covered by Medical Assistance we will need a copy of your card and will verify coverage.  Medical Assistance also has payment limitations on a number of services and items.

Renville County Hospital recognizes Worker’s Compensation cases only when an insurance company verifies that the injury report has been received.

Deposits

Requested deposits may be applicable for all non-emergent services that are not covered or assigned under an insurance policy.  The following deposits will be requested:

Observation Services Room rate per day
Outpatient Surgery $1,000 per procedure
Transitional Care Room rate per day
Maternity Services Room rate per day
MRI Services $1,000 per procedure
Clinic Encounters $144 per encounter
CT Scans $500 per procedure
Digital Mammography $300 per procedure
Interventional Radiology $500 per procedure
Cardiopulmonary Services $300 per procedure
Emergency Room Services $300 per visit
Laboratory Services $100 per lab visit
Therapy Services $100 per session
Outpatient Procedures $500 per procedure
All Other Services $500 per procedure or charges incurred

Payment Arrangements

  • A $50.00 minimum monthly payment on all account balances.
  • Depending on amount owed, a maximum of 36 months to pay account in full.

Credit cards will be accepted for payment of account balances.

Your Hospital Bill

Renville County Hospital will bill your insurance carrier and will do everything possible to expedite your claim.  But you should remember that your policy is a contract between you and your insurance carrier and you have the final responsibility for payment of your hospital bill.  If you are covered under more than one policy, each carrier will determine how to divide payments. If we receive an overpayment on your account, the hospital will make a refund to the appropriate party.  A statement of your account will be sent to you monthly.  Please watch the statement for payments received by your insurance carrier.  Balances “Due by You” must be paid within 28 days unless payment arrangements have been made.

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