Billing & Insurance FAQ

It is your responsibility to notify the clinic of any changes to your name, address, phone number, employer, emergency contact name and/or insurance plan(s). Call us right away at the numbers below if your insurance information has changed since you last registered as a patient, or if you believe your claim may have been denied because of missing or incorrect billing or other personal information. We will update your account information and rebill your insurance with your new information. Have your account number ready when you call Patient Accounts & Support Services 206.520.0400 Monday-Friday from 8:00 a.m. to 5:00 p.m. or message us through MyChart.

After your medical visit, UW Medicine will file claims for services rendered to your insurance plan(s). When your insurance has processed the claim, they will send you an Explanation of Benefits (EOB), telling you what services were billed, what amount was covered by the insurer and what balance you owe. The bill that follows in the mail (or electronically if you have selected to receive your statements this way) will be an itemized statement of charges and balance owed for services received at the UW Medicine clinic you visited. This statement will be sent to the person listed as the "guarantor" on the patient’s account. The guarantor, who may or may not be the patient, is the person responsible for the bill. We kindly request that all statements be paid upon receipt, or within 30 days at a maximum.

UW Medicine participates in many health insurance plans. However, UW Medicine is not included in all plans that each health insurance company offers. Please contact your health insurance plan to verify that your care at UW Medicine will be covered. You can also consult the list of health insurance plans and government programs in which UW Medicine participates. The list is located on our Billing & Insurance webpage under the "Accepted insurance plans" section.

Uninsured or self-pay patients may be required to pay a deposit towards a scheduled, non-emergent visit. Please ask at the front desk or call the appointment line at 206.520.5000 to find out if a deposit is required and how much the deposit will be. Acceptable forms of payment include personal checks, Visa, MasterCard, American Express and Discover Card. You will be billed for any charges that exceed your deposit, and payment is expected at the time of service.

UW Medicine offers financial assistance for the underinsured and uninsured that need help with their bill. For more information and to see if you qualify, you can refer to Billing & Insurance webpage or contact the UW Medicine location you are seeking or have received care.

If you need to obtain insurance coverage, go to wahealthplanfinder.org or call 1.855.923.4633 for information about how to enroll for Classic Medicaid, an Expanded Medicaid program for Washington State called Apple Health, and the various qualified insurance programs available to the public.

Check with your insurance carrier to see if your provider is in network. Your insurance may pay at a different rate for “in-network” providers versus “out-of-network” providers. In-network providers make agreements with insurance companies to provide their services for pre-negotiated rates. Out-of-network providers are not contracted by your insurance company, and you may be responsible for paying in full or at a higher percentage.

Charges which may not be paid by your insurance and may then become your responsibility include: 

• Deductibles 
• Co-insurance and/or co-pays 
• Benefit limitations, i.e. items or services not covered under your insurance plan 
• Medicare program exclusions (see your Medicare handbook for a complete listing). 
• Check your explanation of benefits and/or contact your insurance company with your specific questions.

Insurance claims may also be denied because of missing or incorrect subscriber information on the claim. If you believe your claim was denied for this reason, please call us immediately. Have your explanation of benefits in hand when you call. We will update your account and/or re-bill your insurance. 

Please contact Patient Accounts & Support Services at 206.520.0400 Monday-Friday from 8:00 a.m. to 5:00 p.m. to review the charges and medical records for the service(s) in question and initiate the rebilling process, if necessary.

Please note that for third-party liability cases such as automobile accidents, the patient or his/her guarantor is responsible for payment. UW Medicine will not hold open accounts until settlement is reached with a third-party payer.

Give the clinic your primary and secondary insurance information. If we have complete information, we can bill both insurances right away. This will make it easy for you to manage your bills.

Your insurance coverage will vary depending upon the services you receive. You should request the specific coverage and benefit detail from your insurance company ahead of time for all procedures and visits. You may contact the provider/clinic for an estimate if necessary.

Check with your insurance carrier to see if you have a copay or coinsurance payment. A copay is a set fee established by your benefit contract that you pay at the time of service. If you do have a copay, please bring payment with you to your visit.

A coinsurance payment is the amount you must pay after your insurance has paid its portion. In many health plans, patients must pay for a portion of the allowed amount. For instance, if the plan pays 70% of the allowed amount, the patient pays the remaining 30%.

Generally, this is a matter of timing; the statement was sent before we could get this information entered into our billing system. These payments should be noted on your next bill.

The deductible is the amount a patient pays before the insurance plan pays anything. Check with your insurance carrier to learn the amount of your deductible. In most cases, deductibles apply per person per calendar year. Check with your insurance carrier to learn how close you are toward meeting your yearly deductible.

You will be asked a series of questions required by law at each visit regarding your status, including other insurance you may have, and your retirement date. If you are covered by Medicare, we will submit your claims to Medicare on your behalf.