Our physician-owned and -run philosophy means that nothing gets in the way of doing what we think is best for your care. In addition, you accept financial responsibility for the medical care you receive from us. Please review our financial policies and review your health insurance coverage.

Questions?

For questions or assistance related to billing, fees, co-pays, benefits, Medicare, Labor and Industries, payment policies and financial services, contact our Patient Financial Services department at 206-860-4500 Monday through Friday, 8 a.m. to 4:30 p.m.

Insurance

Relating to Your Visit

Payment and Billing


Insurance

Co-payments, Co-Insurance and Deductibles

All co-payments are due at the time of service. Remaining balances are due upon receipt of your Polyclinic statement. For your convenience we accept cash, checks, debit cards, and most credit cards.

Uninsured patients

If you don’t have insurance coverage, please be prepared to pay $250 for your initial visit and $100 for each subsequent visit with the same provider. If additional services (such as Labs or X-rays) need to be performed, we may request additional deposits.


Relating to Your Visit

Annual Physical and Preventive Care

Some medical plans do not provide reimbursement for annual physicals or other related services i.e. lab, vaccines. It is important that you are aware of your specific benefits and limitations to avoid being held financially responsible.

Advanced Beneficiary Notice and Waiver Forms

Certain visits and procedures may not be covered by your insurance plans. You may be asked to sign a form that states you could be financially responsible for services provided.

Referrals

Some insurance plans require you to have a referral or a pre-authorization prior to your appointment. It is your responsibility to ensure this has been obtained. If we do not have this required referral or pre-authorization then your insurance carrier may deny payment, and the resulting balance becomes your responsibility.

Missed Appointments

We require a 24 hour notice if you need to cancel or reschedule your appointment or procedure. Procedures outside a physician office may require 72 hour cancellation notice. If appropriate notice is not provided you may be subject to a No Show Fee in the amount of $75.00.


Payment and Billing

Returned Checks

There will be a $25 charge for checks returned due to non-sufficient funds (NSF), closed accounts, etc.

Special Payment Arrangements

We understand that there are times you may not be able to pay your bill in full. It is your responsibility to call our business office to make special payment arrangements. Failure to maintain your account in good standing could result in your discharge from The Polyclinic for future care.

Motor Vehicle and Third Party Billing

Motor vehicle and third party injury claims are your financial responsibility. We will provide documentation for you to submit as evidence of services rendered in order to have claims paid. We do not do third party billing.

Online Billing

Online Bill Pay enables you to make payments online after creating an account.