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(509) 332-3548 |
After Hours: (208) 883-5036 | 915 NE Valley Rd. (Near WSU) | |
| Billing and Insurance Information |
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Contracted Insurance Companies The providers at Pullman Family Medicine are “preferred” or “in-network” providers for several insurance companies/insurance networks, most of which are listed below. Not all insurance companies are listed and some may be included in a “network” by a different name. If you are unable to determine whether or not PFM is a contracted provider, the best resource is your insurance company. There should be a toll free customer service number on the back of your card or a website where you will be able to get more information. You may also contact our Billing Office at (509) 334-4867 or email us at administrator@pullmanfamilymed.com. In the event we are not contracted with your insurance company, we will ask that you pay in full at the time of service, however, we do offer courtesy billing to all insurance carriers within the United States. Please see our Financial Policy for further details or contact our office for more details.
We understand that medical billing can often be very confusing. Should you have any questions or concerns please contact our Billing Office at (509) 334-4867 or stop by our office. Patients Without Insurance Coverage Payment in full
at the time of service is expected. We offer a 25% discount
to patients who pay for their services in full at the time of their
visit. If absolutely necessary short-term payment plans are available,
but must be requested prior to the services being performed. Patients
on payment plans will be expected to pay at least ˝ on the date of
service and then the remainder may be split into equal monthly payments,
not to exceed six months. Patients on payment plans are expected to
keep a debit or credit card on file for automatic processing of payments
each month. All balances over 30 days will be assessed interest at the
rate of 18% APR. Q -What is the difference between a “co-pay” and “co-insurance”? A – Co-pay is the term used by many insurance
companies when referring to a set dollar amount that is due from a
patient when they visit a healthcare provider. Usually co-pay amounts
are printed on your insurance card (but not always). Co-pays are
generally collected during the registration or check-in process.
Co-Insurance is another term used by insurance companies when referring
to a percentage of the fees for services. For example if you have an
80/20 plan, your insurance company may pay for 80% of the charges and
you are responsible to pay 20% co-insurance. Often times, co-insurance
amounts are only calculated after you have met your deductible
(out-of-pocket amount paid by you before any insurance payments kick
in). Insurance companies may apply a co-pay and/or co-insurance and/or
deductible depending on the type of service. Please read your benefit
booklet from your insurance for further clarification or contact them by
calling the toll-free number on the back of your card. Your insurance
company is always the best and most accurate resource for benefit and
coverage questions. A – Deductible is another common term used by
insurance companies. Similar to deductibles for homeowner’s or auto
insurance, a deductible is a set amount that you must pay out of pocket
before any benefits are paid by your insurance plan. Deductibles range
from a few hundred dollars per year up to several thousand dollars per
year. If your insurance has a deductible, that amount will have to be
paid by you before they will pay anything towards your claims.
Additionally your deductible will need to be met each year (generally
starting fresh January 1st). If your claim was applied to your
deductible, we try to make sure we put a note on your statement so that
you can easily see how the claim was processed. If you are on a plan
with a higher deductible, we ask that you pay towards your deductible
when you come in for your appointment. Some services (such as preventive
care) are often not subject to deductible requirements and you may see
the terms “deductible waived” or “deductible not-applicable” in your
benefit booklet. It is a good idea to thoroughly read through your
benefit booklet provided by your insurance company before visiting any
healthcare provider, so that you are aware and able to plan for your
out-of-pocket expenses. A – Pullman Family Medicine offers courtesy
billing to all insurance companies in the United States. We try to
maintain contracts with all major insurance carriers in our area. If we
have a contract with your insurance company we will collect any
applicable co-payments, deductibles or amounts for non-covered services
(if known) at the time of service and send you a statement for any
additional co-insurance, deductible, or non-covered services. If we do
not have a contract with your insurance company, payment is expected at
time of service and we will reimburse you any amounts paid to us by your
insurance company. See our current list of contracted insurance
companies. A – Being contracted with an insurance company
means that we have agreed to mutually acceptable terms with the
insurance carrier, which include but are not limited to, the companies
fee schedule for payment of services or “allowables”, the requirements
for submitting claims, administrative requirements and support, along
with several other areas. When we contract with an insurance company
their fee schedule is comprised of what they will allow for any given
service, more commonly known as an “allowable”. For example if our
office charges $100 for a particular covered service and the contracted
insurance companies “allowable” is only $90, then we would adjust $10
off as a “preferred” or “in-network” provider adjustment. Provided that
we are contracted with your insurance company, we will adjust any
“preferred” or “in-network” provider discounts from your bill, however,
please note that you still may have applicable co-payments,
co-insurance, and/or deductibles that you will be financially
responsible for. A – If you are 18 or older, you are legally
responsible for your own account, regardless of who you live with, who
claims you as a tax deduction, or who has the contract with the
insurance company. For patients under the age of 18, the parent(s) or
guardian(s) are responsible for payment. A – If you are involved in an automobile accident,
Pullman Family Medicine will bill your Personal Injury Protection (PIP)
insurance under your auto policy, once as a courtesy. Because of the
often lengthy resolution of these claims, we do ask that you pay for
your visit on the date of service. If your insurance company pays us
directly, we would forward any refund on to you. It is your
responsibility to communicate with your auto insurance company and
pursue reimbursement from the responsible party. In order for us to bill
your auto insurance we need the date of injury, the claim number, claim
adjustor and phone, and the billing address to send the claim to. It is
your responsibility to bring this information with you to your
appointment. If your auto insurance denies the claim, we can then bill
your personal health insurance if you would prefer. Third party injury
claims have the potential to get very complicated. If you have any
questions at all, please don’t hesitate to contact our billing office at
509-334-4867. A – If you are involved in a civil suit or a home or business owner’s accident and are seeking payment from the responsible party, we expect payment at the time of service. As a courtesy to all our patients, we will submit an insurance claim for you to the responsible party. If the third party insurance company pays PFM directly, we will refund any overpayment back to you. We do not hold the responsible party liable for your charges incurred. It is your responsibility to seek reimbursement or any other damages from the responsible party. | |||||||
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PullmanFamilyMed.com | (509) 332-3548 | After Hours: (208) 883-5036 | Fax: (509) 332-5253 | 915 NE Valley Road (Near WSU) | Pullman, WA 99163 |