At Spokane Eye Clinic (SEC), we recognize the importance of our patients knowing and understanding the issues that affect the total cost and out-of-pocket cost of care they receive. We have developed the following written policies to ensure that all of our patients understand the services our Business Office provides and the rights and responsibilities our patients have with regard to payment for services.
Insurance Benefits, Covered Services, and Eligibility
SEC is contracted as a participating provider or preferred provider with a number of health insurance plans. Many of these plans offer more than one insurance product, often with specific limitations. It is the responsibility of the patient to know his or her insurance coverage. As a patient you are specifically responsible for:
- Verifying that Spokane Eye Clinic is a contracted provider for your specific insurance plan
- Obtaining a referral if necessary prior to seeing the doctor
- Determining that you are eligible at the time of service
- Knowing what services (benefits) are covered and what services are not covered by your insurance plan
- Knowing if authorization is required in advance of surgery
- Payment of all co-payments, co-insurance, and deductibles
If you have not already done so, please familiarize yourself with your insurance benefits and cost sharing agreement. If after contacting your insurance plan you still have questions, our Business Office will gladly work with you and a representative of your plan to resolve your questions. We will need you to provide us with the information on your insurance card.
Insurance Plans
The following is a list of insurance plans that SEC is contracted with. This list is subject to change without notice. Please contact your insurance company to inquire about our doctors' participation with your plan.
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Aetna
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Asuris Northwest Health
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Blue Cross of Idaho
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CHAMPVA
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CIGNA
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Community Health Plan of Washington (CHPW)
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Department of Social & Health Services (Washington Medicaid)
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Evercare
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First Choice
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First Health
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Group Health (usually requires a referral)
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Idaho Medicaid
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Indian Health
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Medicare Part B
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Molina Healthcare
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Premera
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Private Health Care Systems (PHCS)
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Railroad Medicare
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Regence Blue Shield
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Secure Horizons
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Spokane Community Care
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Spokane Physician Hospital Community Organization (PHCO)
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Sterling Option Plans
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TriCare
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Uniform Medical Plan
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United Healthcare
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Veterans Administration (VA) (referral required)
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Vision Service Plan (VSP) - Signature Plan Only
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Washington Labor & Industries
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Labor and Industries
Insurance Billing and Statement of Account
If SEC is contracted with your insurance plan, you will receive a statement of account by mail disclosing any balance due after we have billed your insurance plan and it has processed your claim. Our charges will be listed on the statement along with any payments made by your insurance plan and contractual discounts required by our contract. This statement should also correspond to the Explanation of Benefits (EOB) you receive in the mail from your insurance plan. You will receive an individual statement of account on a monthly basis. Payment is due upon receipt. Charges unpaid after 60 days may be assessed a rebilling fee.
Payment and Credit Arrangements
If you are age 18 or older, you are legally responsible for the charges you incur regardless of who you may live with or the Guarantor of your Insurance Plan. Parents are financially responsible for the charges incurred by their children under the age of 18.
If you do not have insurance, or if your insurance coverage is with a plan that SEC does not contract with, you will be asked to make a deposit against the charges you will incur. The Business Office is available to assist with an estimate of your charges, but an exact amount may not be known until the services are provided. You will be mailed a statement of account disclosing any balance owed in excess of your deposit amount.
Co-Payments are due at the time of service. Deductibles and co-insurance will be due at the time of service for all elective surgery. Our contracts obligate us to collect all co-payments, deductibles, and co-insurance from you. Please do not ask us to write off these amounts from your account or accept additional discounts.
We accept personal check, credit card (Visa, Master Card, Discover) and cashier's checks. SEC offers a financing plan. Details are available by contacting the Business Office.
Billing Inquiries
At Spokane Eye Clinic, the Business Office handles all charges, insurance billing, and payment arrangements. Our doctors do not make judgments regarding patient discounts or amounts owed. If you have questions regarding our policies, or your statement of account, please call or write the Business Office at:
Spokane Eye Clinic, PS
Business Office
427 S. Bernard
Spokane, WA 99204
(509) 623-9765
billing@spokaneeye.com