Billing & Insurance FAQs
Answers to Common Questions About Your Bill
If you have questions about your bill, keep reading to see some answers to questions we receive from patients. You can also contact our Patient Services Department at (509) 436-4020 or toll-free at (888) 499-4801.
Patient Financial ServiceS staff are available Monday through Friday from 8 a.m. to 5 p.m. Please call (509) 436-4020 or visit any of our in-patient areas.
Billing & Insurance FAQ
- If my insurance company has a co-payment requirement, can I wait for Confluence Health to bill me after my insurance processes?
- When is payment of my bill expected?
- What if I cannot pay my bill by the due date?
- If I cannot afford to pay the bill I receive? Are there any options?
- Can I dispute how my insurance paid my claim?
- How do I dispute my bill with Confluence Health?
- There is a doctor's name on my bill I don't recognize. Why is this?
- Why am I receiving a bill for services conducted at your hospital when I was seen at one of the clinical offices?
- How is a charge set for my services?
- Which insurance companies do you bill?
- What does “contracted” insurance and “allowable” mean?
- What happens if Confluence Health is not contracted with my insurance company?
- What if I am injured on the job?
- What if I am injured in a motor vehicle accident?
- Do you accept Medicare assignment?
- Do you take monthly payments or set up payment plans?
- What if I am in the middle of a lawsuit?
- Who is responsible for payment and follow-up with the insurance company?
- When will I receive a statement?
Questions About Online Bill Payment
- What bills can I pay online?
- Is it secure to submit my financial information?
- Can I view my account balance online?
- Who can I call with questions about my account, changes in personal information, or making payment arrangements?
1. If my insurance company has a co-payment requirement, can I wait for
Confluence Health to bill me after my insurance processes?
Confluence Health expects co-payment amounts to be paid at the time of
service. Please be prepared to pay your co-payment when you check in.
We accept, Visa, Mastercard, Discover, checks and cash.
2. When is payment of my bill expected?
Confirmation of your information will be done prior to or at admission/check-in.
At this time, you will be given the opportunity to make payment or payment
arrangements. You may also be asked for payment on any outstanding balance
when you arrive for your appointment. Payment in full is expected by the
due date on your statement unless you establish a payment plan.
3. What if I cannot pay my bill by the due date?
You should contact the Patient Financial Services Department at (509) 436-4020
or toll free at (888) 499-4801 to discuss a payment plan, or visit any
of our in-person areas listed.
4. What if I cannot afford to pay the bill I receive? Are there any options?
Please contact Patient Financial Services at (509) 436-4020 or toll-free
at (888) 499-4801 to discuss payment options,or visit any of our in-person
areas for our
Financial Assistance Program.
5. Can I dispute how my insurance paid my claim?
If you believe your insurance company did not pay for your services properly,
please call your insurance company first.
You have the right to appeal any decision made by your insurance company.
Simply call the number on your insurance card or on the Explanation of
Benefits provided by your insurance company. Your insurance company can
advise you of its dispute procedures.
6. How do I dispute my bill with Confluence Health?
Please contact Patient Financial Services at (509) 436-4020 or toll-free
at (888) 499-4801 or visit any of our in-person areas where one of our
representatives can assist you.
7. There is a doctor's name on my bill I don't recognize. Why is this?
There are several reasons you may not recognize a doctor's name that appears
on your bill. If the service being billed is for reading an X-ray or a
pathology report, or for the doctor who gave you anesthesia, your bill
will have the name of the doctor who performed these services. You may
not have met with these doctors during your visit, but they are an important
part of the medical team.
8. Why am I receiving a bill for services conducted at your hospital when
I was seen at one of the clinical offices?
There are different types of services, such as reading lab tests or X-rays,
that are sent to our hospital for analysis or interpretation. These services
are billed separately from the services provided at the clinical offices.
9. How is a charge set for my services?
Charges are determined using a combination of three factors:
-
Costs to perform the service
-
Market competitiveness: competitor prices and availability of services in the marketplace
-
Reimbursement rates: amounts to be paid under health plan contracts
Prices are reviewed annually for appropriateness and reasonableness. Additional reviews are done on an ad hoc basis as new information is identified related to any of the three factors.
10. Which insurance companies do you bill?
We accept and bill most major insurance plans. We ask that you show us a copy of your medical insurance card so we can set up the correct billing information. Check out our In-Network Plans/Payers page.
11. What does “contracted” insurance and “allowable” mean?
“Contracted” insurance means that we have agreed to accept that particular insurance company’s fee schedule for payment of our services. Allowable is another term used for this. Although we accept the insurance allowable, there is usually a portion, percentage, deductible or co-pay for which the patient has financial responsibility.
12. What happens if Confluence Health is not contracted with my insurance company?
If Confluence Health is not contracted with your primary insurance company, we will still bill your insurance as a courtesy to you. You will be financially responsible for any portion of your bill that your insurance company does not pay
13. What if I am injured on the job?
The Occupational Health Department at Confluence Health is available to treat your on-the-job injuries. You will need to complete an accident report. If your Washington-based employer is self-insured, your employer will provide you with the report and claim number. If your Washington-based employer is insured through the Washington State Department of Labor and Industries, you will be asked to complete a report at the time of your visit. Confluence Health will bill the on the job injury claims to the appropriate insurance carrier for you. If the insurer approves your claim, you will not be responsible for any work injury-related charges.
14. What if I am injured in a motor vehicle accident?
If you seek treatment for motor vehicle-related accidents, Confluence Health will send a notice offering to bill your motor vehicle insurance company for you. We provide this service as a courtesy to you. You will be responsible for any portion not paid by your automobile insurance carrier.
15. Do you accept Medicare assignment?
All providers at Confluence Health are participating providers with the Medicare Program. You are responsible for any deductibles and co-insurance portions.
16. Do you take monthly payments or set up payment plans?
If you are financially unable to make full payment at the time of service, our business office can set up a payment plan. You should request this option as early as possible, preferably on the first visit. If you feel you are not able to comply with our payment plan, you may apply for an extended payment plan which requires the completion of a personal financial statement. Based on your financial statement, it is possible that we will be able to forgive a portion (or all) of your bill. Having all patients apply in this same manner enables us to treat all of our patients fairly.
17. What if I am in the middle of a lawsuit?
A lawsuit is an action taken by you against another party and does not involve us. Therefore, we cannot wait for settlement or judgment to be paid. You are responsible for your account, not the third party.
18. Who is responsible for payment and follow-up with the insurance company?
If you are 18 or over, you are legally responsible for your own account, regardless of who you live with, who has the contract with the insurance company or who claims you as a tax deduction. If the patient is under 18, BOTH parents, despite divorce or other separating agreements, or the legal guardian are responsible for payments.
We ask that you be fully responsible for knowing the specifics of your particular insurance contract. Examples of these specifics include co-pays, deductibles, second opinions, preauthorization’s, preferred providers, covered and non-covered services and preferred hospitals. Our office is staffed to request preauthorization from your insurer for your hospital and/or surgical visit. This does NOT guarantee payment. Payment will be made according to YOUR contract.
Confluence Health cannot accept the responsibility for collecting your insurance reimbursement or negotiating a settlement on a disputed claim. We can provide you with the necessary medical information to assist you.
19. When will I receive a statement?
Statements are created based on your Confluence Health activity. You will receive a monthly statement for those months when you have an outstanding balance or there are transactions posted to your account. At the time transactions are posted to your account, if we are contracted with your insurance company, you will also receive a notice of insurance billed. This notice will tell you which insurance was billed, when it was billed, and the service that was billed. This is also known as an Explanation of Benefits.
If you have any questions about our credit policy or your bills, please contact our Patient Financial Services Department and we will be happy to assist you.
Questions About Online Bill Payments
1. What bills can I pay online?
You may pay your doctor bill, hospital bill, or any bill you receive from any Confluence Health source online using MasterCard, Visa, or Discover. You may also pay from a bank account, such as checking or savings accounts. Payments are processed within two (2) business days, and there is no fee for making an online payment.
2. Is it secure to submit my financial information?
Yes. The transaction portion of our website is protected with the latest encryption software.
3. Can I view my account balance online?
Online access to account information is not currently available. If you have any billing questions, please call the hospital or clinic billing staff.
4. Who can I call with questions about my account, changes in personal information, or making payment arrangements?
If you have any questions or would like to talk to a Patient Financial Service Representative, please call:
- Patient Financial Service staff between 8 a.m. to 5 p.m., Monday through Friday. 509.436.4020 or visit any of our In-Patient areas listed.
