Billing and Insurance

Our physicians are contracted specialist providers with many preferred and managed care insurance plans. In today's confusing insurance environment it is critical for you to be educated to the requirements of your particular plan. Some plans require prior authorization for specific procedures or restrict which outside services (laboratory or x-ray) can be utilized. It is a good idea to review your insurance benefits prior to your visit. If you do not comply with the requirements of your plan, you may be held personally responsible for your bill. Our insurance coordinators are available to assist you in these matters.

We offer courtesy billing for all insurance plans if you provide us with a current copy of your insurance card.

We are providers with the following insurance plans:

  • Regence BlueShield 
  • Aetna 
  • Premera Blue Cross
  • First Choice Plans
  • Healthy Options Plans:
    • Community Health Plan of Washington
    • Molina Healthy Options
    • Coordinated Care
    • United Healthcare Community Plan
  • Other Plans:
    • Cigna 
    • Provider One/Apple Health
    • First Health
    • United Healthcare

 

Special Note Regarding Medicare

Our office opted out of the Medicare Program on October 1, 2000. We are unable to submit claims to Medicare, and you may not submit them yourself. Therefore, in most instances, patients with Medicare as their primary insurance will be financially responsible for charges. Please contact our office if there are any questions regarding this Medicare issue.

Special Note Regarding Affordable Care Organizations "ACO"

While we may be contracted with your insurance for specific plans, many insurances have developed limited access networks.  It is the patient responsibility to verify if we are contracted on your unique plan.  Our tax ID numbers are listed for your convenience.  

91-1004602

30-0832785

If You Are Not Using or Do Not Have Insurance

If you are not using insurance coverage, we require that all initial visits be paid at the time of service. Payment will also be required for all elective procedures, medications, or medical devices not covered by insurance. All account balances are due in full 30 days after services are provided, or 30 days following insurance response. For your convenience, we accept cash, personal checks, and DISCOVER, AMERICAN EXPRESS, VISA, or MASTERCARD.

Billing For Obstetric Care

Your OB fees are submitted to your insurance company and/or billed to you at the time of your delivery. Early in your pregnancy, we will determine from your insurance company what percentage of the fee is likely to be paid by them. The balance will be billed to you in budget payments, to be paid prior to delivery. If an overpayment results, this will be promptly refunded to you after delivery.

Statements are sent monthly. Note that the total estimated charges are printed, but your budget payment is only that amount under "budget payment". If you are having trouble meeting your budget payments, please contact our business office. Payment arrangements can often be made.

The OB fee is a "package" which includes most of your prenatal visits, vaginal delivery, hospital rounds during your post-partum stay, and a post-partum office checkup. Laboratory tests, Ultrasound, Non-Stress tests and non-routine office visits will incur additional charges. If you are hospitalized during or after your pregnancy for a non-delivery reason, this may also incur an additional fee. A cesarean delivery carries a higher fee and there is a charge for an assistant surgeon. Circumcision, tubal ligation, amniocentesis, and other non-delivery procedures are billed separately. If you have anesthesia, Overlake Anesthesiologists bills you directly. In addition, Overlake Hospital will bill you for all hospital associated charges.

High Risk/Complex Pregnancies

The fee for your obstetric care may be higher if we determine your pregnancy or delivery to be complex or high risk. Examples include preterm labor, twins or complex medical problems complicating pregnancy.

Pre-certification For Hospital Admission

When we call for insurance coverage information, we will also check to see if your insurance requires pre-certification for hospital admission. If required, we will then notify the pre-certification department of your estimated due date. It is your responsibility to call your insurance company shortly after you are admitted. In most cases, if you do not call, payment for hospital services will be reduced, increasing your out of pocket expense. It will also be necessary for you to register with Overlake Hospital Medical Center by your 30th week. You may do this either on the hospital form that we give you, in person at the hospital, or on-line at Overlake Hospital Preregistration

Other Fees

Please contact our business office if you need further information or estimates of other charges such as postpartum tubal ligation, assistant fees, etc. We also recommend you contact Overlake Hospital Medical Center (425-688-5000) to confirm they are participating with your insurance company, before you deliver!

Our Goal is High Quality Medical Care

We are sensitive to your concerns about medical costs and share a desire to keep charges to a minimum. Our first and foremost desire, however, is to provide you and your unborn child the highest quality medical care. If at any time you have concerns regarding the medical necessity or cost of a recommended treatment, please talk with us.

We Are Here To Help You

Insurance and billing procedures can often be complex and confusing. To help you take full advantage of your benefits, we have an experienced insurance department in our office to guide you. Please call us with your insurance related questions. For additional billing and insurance questions, please contact our business office at 425-455-0244. Any of the following individuals will be happy to help you:

Tammi Campbell - Patient Account Billing

425-455-3771 or Email Tammi

GeNay McIntosh - Patient Account Billing

425-455-4715 or Email GeNay

Tonya Owens - Patient Account Billing

425-468-8802 or Email Tonya

Suzanne Parker-Dixon - Office Administrator

425-455-9528 or Email Suzie