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Presbyterian Healthcare System Payment Expectations
At Presbyterian, our first priority is taking care of our patients and facilitating excellent care.
To maintain our ability to provide the best healthcare possible to New Mexicans, the following payment expectations apply for non-emergency services for both insured and uninsured patients seeking care at Presbyterian-owned facilities.
In the event of an emergency, Presbyterian will provide the necessary medical treatment regardless of one's ability to pay.
- For insured patients: Your deductible, copayment and/or co-insurance, if applicable, are due at the time of service. A deductible is the amount you must pay before your benefit plan starts paying any portion of your medical services. After your deductible is met, you may have to pay a copayment (a set dollar amount) or co-insurance (a percentage of the cost) for your medical care. Some plans do not require a deductible. Please refer to your benefit plan documents for the amounts that you must pay for different services. If you are scheduled for a non-emergency medical procedure or surgery, we may contact you before your appointment to provide you an estimate of your cost and to collect your copayment, deductible, and/or co-insurance.
- For uninsured patients: You will be asked for payment in full. Presbyterian offers uninsured patients a 25% discount on all services. We will provide you an estimate of the cost so you are able to make an informed decision as to whether or not you would like to proceed with the requested services.
- Financial Assistance: Financial assistance and counselors are available to our patients who are uninsured or underinsured, and have difficulty paying for care. Presbyterian offers payment options, including payment plans for those who qualify and charity assistance. If you would like information about our financial assistance policy, please call (505) 841-1406.
- Presbyterian hospitals and clinics (including Presbyterian Medical Group) accept cash, checks, debit and credit cards for payment.
- If you are unable to pay on the day of your appointment, or earlier if requested, we can reschedule your appointment.
- If you are approved for payment arrangements, you must pay according to the agreement terms. If you do not pay according to your agreed upon commitment, your account will be considered delinquent and will be subject to additional collection terms. Please note this may include the inability to schedule future appointments with your physician, as well as referral to an outside collection agency. This action may impact your credit status.
How you can keep your out-of-pocket costs down
To make the most of your health care dollar and minimize the amount of out-of-pocket costs you have to pay, make sure you understand how your health plan works.
To get specific information about your health plan, call your health plan's customer service number. You may also find your copayment and other out-of-pocket amounts listed on your Member ID card.
Here are some general tips on minimizing costs:
- Stay in-network. Your health plan may limit you to a specific network of health care practitioners and facilities. Check to make sure that you are getting your health care from doctors and facilities in your health plan's network. In most cases, you will pay the lowest copayment or other costs when you stay in the network. Your health plan may not pay for any costs when you go to out-of-network practitioners so you may have to pay ALL of the costs of the visit.
- Know the amount of your copayment or other out-of-pocket costs. This will help you make an informed decision about what doctor to see. You may pay a smaller copayment to see your Primary Care Practitioner (PCP) than to go to an Urgent Care. In most cases, you can look at your Member ID card in advance for the amount of your copayment or co-insurance. If you don't know the amount of your copayment or co-insurance, contact your insurance company using the phone number on your Member ID card so you are prepared to make the payment at the time of service.
- Is your service covered? Your health plan may not cover some services, procedures or prescription medicines. In this case, you will have to pay all of the costs. Your health plan can help you know if your services will be covered.
- Plan Ahead. Estimate your medical expenses for the year (especially for elective procedures) and set aside pre-tax dollars with a Flexible Spending Account (FSA), Health Savings Account (HSA), or something similar. Talk to your Human Resources or Benefits Department about options available to you.