Surprise Billing and Good Faith Estimates

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Learn more about surprise billing or how to receive a good faith estimate.

Machine-Readable File

Pursuant to South Dakota Codified Law 58-17K-5, we have made our South Dakota pharmacy prescription drug file in a machine-readable format that includes negotiated rates with in-network pharmacies.

In compliance with Transparency in Coverage Rules, we have made our files in a machine-readable format that includes negotiated rates for in-network providers and historical allowed amounts and billed charges for out-of-network providers. DAKOTACARE is working closely with its vendor to prepare Machine Readable Files for posting to its website to meet the Transparency in Coverage rules. We anticipate being able to post these files soon. For more information, email ahpedi@avera.org.