At Virginia Mason Franciscan Health, we’re here to help you find answers to your questions about billing, insurance coverage and financial assistance.
Although those services are part of your care at Virginia Mason Franciscan Health, based on the location your care was provided, the providers may bill for these services separately from the hospital or the clinic.
The only provider claims included in the Virginia Mason Franciscan Health patient statement are those providers employed by Virginia Mason Franciscan Health, Franciscan Medical Group or Harrison Health Partners.
The most common reason is that your insurance benefits don’t cover 100 percent of what the insurance allows for your service. There are multiple reasons, including but not limited to:
Your insurance company will send an explanation of benefits (EOB) to you that will help you understand what they did or didn’t cover.
Depending on when you made the payment arrangements on your past bills and when you subsequently received services that weren’t part of those past invoices, you’ll need to call the Billing Office and add your newest bill to your payment arrangement agreement. For each new visit where you may owe a liability, once you have the new bill, you can add that to your payment agreement. As required, we must have your authorization to add that new balance to your previously set-up payment arrangement, because the new balance may also change the minimum amount due each month.
Especially for our patients for whom we’re billing insurance for payment of services, we depend on the timing of the insurance payment before we can bill you for your portion. In some cases, insurance payers will want additional information on one account and yet pay quickly on another. Once the insurance pays, we’re able then to either bill any applicable remaining balance to any known, applicable secondary payer, or move the balance to patient responsibility. When the balance is moved to patient responsibility, a statement is produced and mailed to you.
There are few reasons this could occur:
We use multiple print vendors for our statements and letters depending on the type of statement and where the payment needs to be sent. Here are the current locations for return addresses you may see:
All these statements and letters will have the Virginia Mason Franciscan Health logo.
To better serve you, we have teams specialized in handling your questions or needs. This normally ensures that we’re reducing wait times as much as possible. They’re all here to serve you and meet your needs, but if they can’t, they know how to get you to the right place. You should never feel a difference in the level of service regardless of whom you are speaking with. It should feel seamless to you; if it doesn’t, please ask to speak to a supervisor.
We understand that health care billing can be confusing and we’re here to help. If your question wasn’t answered by any of the above, please reach out to us. We’re committed to continuous improvement in our service.
You should contact your insurance company, see our accepted insurance plans or contact our billing offices:
When a healthcare provider is “in network” it means the insurance company will cover a higher amount of the charges. When a provider is “out of network” you can still go to this provider, but you’ll be required to pay a larger percentage of the bill.
Yes, you’re expected to pay your co-payment when you arrive. Your insurance card should indicate the dollar amount of the co-payment required for each type of service. If you have questions regarding co-payment amounts, please contact your insurance company or your employer.
Yes, we’ll bill your insurance company for you, provided you’ve given us complete insurance information. This includes the name of the company, the address to which claims are to be billed, your policy identification number, your group number (if applicable), and a phone number.
Health insurance policies vary widely on which procedures, services, or items an insurance company will cover. To maximize your health insurance benefits, familiarize yourself with the policies and benefits outlined in your health insurance handbook or contact your health insurance customer service department for policy and benefit verification.
Questions to ask your insurance company:
Many insurance companies have amounts the patient must pay. These are called deductible, co-pays or co-insurance payments. If your insurance plan requires you to pay a deductible or co-insurance, the balance will be billed to you. If you have a question about why your insurance company didn’t pay part of a claim, call your health insurance company directly.
These are documents showing a detailed listing of how your insurance company processed your claim or bill. An EOB or EOP is mailed by your insurance company directly to you.