Insurance and Registration
The Polyclinic participates with most major insurance carriers. It is your responsibility to provide us with current information necessary for billing including your government-issued ID, address, phone number and a copy of your insurance card at each visit.
You will receive a statement each month for any balance left on your account. Your insurance is a contract between you and your insurance carrier, which may not cover all your care. We cannot accept responsibility for non-covered insurance claims or negotiating a disputed claim.
Some insurance plans require a referral or a pre-authorization prior to your appointment. It is your responsibility to ensure this has been obtained.
If we do not receive this required referral or pre- authorization, your insurance carrier may deny payment, and the resulting balance becomes your responsibility.
Relating to Your Visit
Annual Physical and Preventive Care
Some insurance 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 plan limitations.
Advanced Beneficiary Notice and Waiver Forms
Certain visits and procedures may not be covered by your insurance plan. You may be asked to sign a form that states you could be financially responsible for services provided.
We kindly ask that you respect our cancellation policy of 24 hours notice or more to cancel or reschedule your appointment or procedure. Procedures outside a physician’s office may require 72-hour cancellation notice. Multiple missed appointments without notice may result in discharge from The Polyclinic for future care.
Payment and Billing
Collection of 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 checks, debit cards, and most credit cards.
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.
There will be a $25 charge for checks returned due to non-sufficient funds (NSF), closed accounts, etc.
Online Bill Pay
You have the option of paying your bill online after you create an account.
We understand there are times you may not be able to pay your bill in full. It is your responsibility to call Patient Financial Services at 206.860.4500 to make special payment arrangements. Failure to maintain your account in good standing could result in your account being forwarded to collections and 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. Claims that are not paid within 30 days become your responsibility.