Insurance/Financial Policy

Bellingham OB/GYN, a division of Unified Women’s Healthcare of Washington, is committed to providing you with the highest quality medical care. Because patients are ultimately responsible for the charges associated with their care, even when insurance is in place, you may find the following information helpful. We realize you have choices for your medical care and appreciate your choosing Bellingham OB/GYN.

Patient Responsibilities:

You can help ensure an efficient experience by assisting with the following:

  • Providing us with your picture identification, insurance card and Social Security number to enable us to submit your claims timely and accurately
  • Knowing your insurance benefits and limitations
  • Ensuring there is an authorization for our providers to treat you if it is required by your insurance, including obtaining a referral
  • Providing us with copies of any pertinent medical records, including tests (MRI/CT/US) and x-rays
  • Paying your estimated portion of the charges at the time of service
  • Paying any additional amount owed when due
  • Completing required incident/accident forms within 30 days of date of service
  • Maintaining a current account with Bellingham OB/GYN at all times
  • Providing us with at least 24 hours advance notice should you need to cancel or reschedule an appointment

Please note that co-payments, co-insurance and deductibles are a contractual agreement between you and your insurance carrier. We cannot change or negotiate these amounts.

Insurance

We are contracted with the following insurance carriers:

  • Aetna
  • Cigna
  • First Choice
  • Healthy Options/CHPW/Apple Health/Molina/United Healthcare Community Plan
  • Kaiser Foundation Health Plan of Washington {formally known as Group health}
  • Medicaid/ Washington Apple Health
  • Multiplan
  • Premera Blue Cross
  • Regence Blue Shield
  • United Healthcare
  • Medicare: Problem focused visits only
  • Humana: Referral basis only
  • Tricare: Referral basis only

Payment

Payment Options – We accept cash, checks, major credit/debit cards and money orders for payment (no postdated or third party checks). We charge a $35.00 NSF fee for any returned checks.

Alternative Payment Arrangements – If you are unable to pay your balance when due, please contact our business office to make alternative arrangements. Any patient with a past due amount may be denied additional service until the amount is paid or the patient is complying with an alternative payment arrangement.

Bankruptcy/Prior Bad Debt – Patients who have previously filed for bankruptcy or never satisfied their payment obligations for prior episodes of care with Seattle OB/GYN Group or other Proliance Surgeons care centers may be required to pay for their portion of new charges at the time of service.

OB Benefits and Billing Policies

Our obstetrical fee covers the services included in a standard vaginal delivery or cesarean section. Additional services may be required and billed during your pregnancy and delivery. In addition to the obstetrician’s bill, you may receive bills from the laboratory, hospital, anesthesiologist, radiologist and pediatrician. As a courtesy to you, we will contact your insurance company to obtain an estimate on your benefits. Remember that this is an estimate only, based on proposed services and information supplied by your insurance carrier. Please notify our business office immediately if your insurance changes during your pregnancy. The estimated patient balance is due in full by your 28th week of pregnancy. If you do not have insurance we require half of the fee for total care at your initial visit and the balance paid by your 28th week of pregnancy. You will be asked to speak with our business office when scheduling.

Surgical Services

For any gynecological surgeries or in-office procedures, there will a deposit required that must be paid prior to services being performed. This deposit can be paid over the phone at the time of your pre-operative visit. This deposit varies based on insurance type and procedure type. Please contact a member of our billing department to determine your in-office procedure deposit.

Self-Pay

Patients who do not have insurance coverage (or proof of coverage) or who choose to pay for non-covered services must be paid in full at the time of service. If you cannot pay the full amount then you must make satisfactory payment arrangements with our business office prior to receiving services.

Motor Vehicle Accidents (MVA) Insured and Third Party Patients

We do not extend discounts for MVA-insured accidents, third party insurance claims or in other cases when patients may be reimbursed in full. We will bill the MVA insurance carrier one time. The bill becomes your responsibility if not paid by the carrier in 30 days. We regret that we are not in a position to confer with attorneys or defer payment obligations while a case settles. If your personal injury protection benefit on your MVA policy is exhausted, we will bill your private insurance at your request provided we are furnished the necessary information at the date of service.

Workers’ Compensation

If your visit is work-related, we will need the case number and carrier name prior to your visit in order to bill the workers’ compensation insurance carrier. If your workers’ compensation claim is not yet accepted and you have no other insurance, we require a $200 deposit that will be refunded after the claim has been opened.

Cancelation fees / reschedule appts

No Show
Please provide us with at least 24 hours advance notice if you need to cancel or reschedule an appointment. We may charge a fee for missed appointments. Please provide us with at least 48 hours advance notice if you need to cancel or reschedule an appointment and an interpreter has been scheduled. Otherwise, you may be charged for the interpreter.

Forms
There are charges associated with our completion of some forms required by your insurance company and/or employer. We require payment of the charge before returning the completed form to you. A signed Release of Information may also be necessary. Please allow 7-10 business days for us to complete forms.

            FMLA Packets – $40

            Any additional forms – $12 each

Refunds
Please note, if you have moved after receiving services from our clinic, it is vital you contact our office and update your address. This is essential if you are owed a refund by Bellingham OB/GYN. If we must stop payment on a check you did not receive, there is a $35 fee placed onto the patient.

 Preventive Care
All women age 18 or older need annual gynecologic examinations, including a pelvic examination, as do sexually active adolescents younger than age 18. The well-woman visit is a key part of preventive care; it includes a discussion of the patient’s health history and reproductive health care needs, a physical examination, including a weight and blood pressure check, a clinical breast examination, and various tests depending on a woman’s age and risk factors for disease. Most insurance plans now provide 100% coverage for preventive services. Keep in mind there may be lab tests ordered that do not fall within the preventative guidelines of your insurance plan. It is important that you know which lab tests are allowed with a preventative exam.

IUD Benefits
Most insurance plans now offer 100% benefits for IUD and other contraceptive devices. The insertion of IUD or Implantable Contraceptive device may require the use of a paracervical block and often an ultrasound is done immediately after placement to check the position. These services may not be covered at the 100% benefit level or may be subject to annual deductible and therefore not paid at 100% even though the IUD or Implantable Device is.

Women with Medicare
Our office is a participating provider with Medicare because we feel a moral and civic duty to provide services to this population of patients; many offices choose not to see Medicare patients. Medicare never covers a well woman exam and requires us to inform the patient by use of an Advanced Beneficiary Notice of Noncoverage (ABN) for this or any other service we know or have reason to believe will not be covered. The Federal Government has very specific requirements and guidelines for how we submit claims for these services. Medicare will pay for a Pap test, pelvic exam, and clinical breast exam every 24 months and for some women at high risk every 12 months. Because Medicare does not pay for this exam we “carve out” the charge for the Pap smear, pelvic exam and breast check from our fee for the appropriate preventative examination with the balance being due from the patient for the portion not covered by Medicare. We are required by law to bill this balance to the patient and are not allowed to write off the balance unless we receive proper proof of financial hardship.