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Billing
Information
Important
Facts About How Our Billing Works
Insurance Plans We Work With
Billing for Obstetric Care
Our Business Office Staff
Important Facts
about how our billing works
There are hundreds of insurance carriers and plans in place today.
Their rules and policies change on a daily basis. We try to keep up to
date on the major plans, however it is impossible for our staff to know
the details of each and every insurance plan we encounter.
We
encourage our patients to learn everything they can about their
insurance policies. The best way to avoid surprise bills, is to be
pro-active and prevent them before they occur! We do not routinely
confirm coverage before office calls. If you have questions, you must
call your insurance company.
As
a patient, you are responsible for payment of services you receive in
our office, regardless of coverage. Medical insurance is a contract
between you and your insurance company. You are ultimately responsible
for any unpaid balance.
Some insurance companies do not cover annual or preventive care, even
though the American College of Obstetrics and Gynecology recommends
routine pelvic, breast exams, mammograms and pap smears.
Another issue is lab work. We work primarily with
Pacific Physicians Lab. It
is your responsibility to make sure your insurance company will cover
lab work sent to Pacific Physicians Lab
Co-payments are due at the time of service. For your convenience, we
accept cash, checks, debit cards, MasterCard and Visa. We are also
listed with many banks allowing you to pay your bills on line.
Please keep our office up to date on your insurance information. Even
little changes to your policy can effect how your bills are paid by your
insurance plan.
If
you have any questions at any time, please call our Business Office at
425.271.4303
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Insurance Plans We Work With
We are providers with the
following insurance plans: (highlighted information contains link to
insurance company web site)
Boeing Employee Medical Plans
Regence Blue Shield Plans
Regence Care
Regence Selections
Aetna US Healthcare
- We do not participate in the Aetna HMO Product
First Choice Health Network
Premera Blue Cross
PPO
Preferred
Health Plus
Basic Health
Blue Choices
Healthy Options
Plans
Community Health Plan
Molina Healthy Options
One Health Plan - Great West Life
United Healthcare
Uniform Medical Plan
-
Washington Healthcare Authority
First Health
Private Healthcare Systems/Multiplan
Medicare
(assignment accepted)
DSHS - Non-pregnant patients by MD referral only
We are happy to
submit bills for those plans of which we are members. As we bill over
400 insurance plans, we ask our patients to be responsible for
determining what is covered by an insurance plan. We bill only the
primary insurance plan.
For additional
billing and insurance questions, please contact our business office at
(425) 271-4303
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Business
Office Staff
Sandy
- Insurance Coordinator
Peggi - Medical Records, Surgery
Scheduling
Cyndi, Bookkeeping
Leann Harris, Clinic Administrator
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Billing for Obstetric Care
Our goal is to make the financial aspect of
your pregnancy as painless as possible! During the first trimester of
your pregnancy, we will contact your insurance company to verify your
eligibility and benefits. Please note, this is not a guarantee of
payment. We recommend (in every case) you contact your insurance company
to confirm this information. If your insurance should change during your
pregnancy, it is your responsibility to notify our business office as
soon as possible.
During your pregnancy care, we bill only for
lab work performed in our office, ultrasound, and other pregnancy
related care. Your insurance company is billed for your OB care and
delivery after you deliver. Therefore, we ask that you pay all out of
pocket expense by the eighth month of your pregnancy.
Our Fees
Our fees are based on 15
visits, your delivery and postpartum care (if provided within eight
weeks of your delivery). If you should transfer care, you will be billed
for all care provided up to the time of your departure.
What our Fees Include
Complete obstetric care.
Each physician employs a primary nurse, who is available to answer your
more complex pregnancy related questions during our regular business
hours. We also staff a full time phone call nurse, who can help you
with basic pregnancy questions and prescription refills.
You will receive your choice of "While
Waiting" or "What to Expect When You Are Expecting" - guides to
pregnancy and childbirth. We will also provide you with an information
packet to help you throughout your pregnancy.
Our Fees do not include:
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Fetal stress tests
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Blood work, lab tests, pap smears, etc.
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Office call for non-pregnancy related
care
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House calls or night office calls
-
Anesthesia for childbirth
-
Hospital charges
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Circumcision
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Newborn hospital care
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Ultrasound
High Risk/Complex Pregnancies
The fee for your obstetric
care may be higher if your physician determines your pregnancy or
delivery to be complex or high risk. Examples include pre-term labor,
twins or vaginal delivery following a previous c-section. Cesarean
deliveries require an assistant surgeon. Please check with the business
office for further information on assist fees.
Pre-certification for Hospital Admits
When we call for insurance
coverage information, we will also check to see if your insurance
requires pre-certification for hospital admits. If required, we will
then notify the pre-certification department of your estimated due date.
It is your responsibly to call your insurance company shortly after, or
before you are admitted. In most cases, if you do not call, payment for
hospital services will be reduced, increasing your out of pocket
expense. In addition, some plans require the patient or insured to
actually make the call.
Other Fees
Please contact our
business office if you need further information or estimates of other
charges such as postpartum tubal, assist fees, etc. We also recommend
you contact
Valley Medical Center
(425-228-3450) and Valley Anesthesia Associates (425-643-1320) to
confirm they are participating with your insurance company, before you
deliver!
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