South Dakota Provider Network News

Spearfish Regional Hospital

Spearfish Regional Hospital’s contract expired on October 31, 2006. This means that services received on or after November 1 at Spearfish Regional Hospital will be reimbursed at the non-network level.

Wellmark members will continue to receive benefits for covered services provided by Spearfish Regional Hospital on or after November 1, 2006, but with the possible following changes:

• Members may have to file their own claims.
• Members may receive any benefit payments directly from Wellmark Blue Cross and Blue Shield and be responsible for paying the provider directly for services received.
• If there is a difference between what Spearfish Regional Hospital charges and what Wellmark allows for reimbursement, members may be billed for the difference, a practice called balance billing. If this occurs, members would be responsible for the balance billed amount, as well as any applicable deductible, coinsurance percentages, or copayments.

Please note that all other hospitals in South Dakota contract with Wellmark.

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