Patients & Visitors

Financial Arrangements

Patient Billing

Our Mission
As people of Providence we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.

Welcome to Providence
Providence is committed to providing you with the best medical care possible. This includes the handling of your bill. We want to help you understand your bill and answer any questions you may have. If you still have unanswered questions after reading this page, please contact us for assistance.

Regarding your bill:

You may receive more than one bill
When you receive medical care from one of our Providence locations, you may receive more than one statement for the treatment received during your visit. Many services must be divided between provider (MD, DO, PA, ARNP, NP, etc) and the supplies and/or staff resources used in order to meet federal and state billing regulations. This may result in two separate billings for a single date of service, which may also lead to two explanations of benefits from your payor and/or two statements forwarded to you for services. Common examples are the doctor’s visit with laboratory or x-ray services performed.
Free-standing Clinic bills include the doctor, staff and supplies all on one bill.
Provider-based Clinics and Outpatient Hospital Departments, which divide the doctor from the hospital supplies and staff. In some cases, the charges may be more in a provider-based clinic due to the hospital resource expense.
Additional Providence services, which may be billed on a separate statement include; anesthesia, emergency services, home health services, hospice, independent diagnostic testing facilities, operating room services, private nurses, x-ray procedures, etc.

If you believe a charge on your bill is incorrect, please contact a Providence Financial Counselor.

Getting Help
If you need financial help with your bill, please speak with a financial counselor at our hospital. You can call or meet with a financial counselor in person at the hospital. If you have insurance or are covered under Medicaid or Medicare, please share that information with our financial counselors when you seek care at Providence hospitals. This will help them better assist you.

Saint Mary Medical Center
509-522-5804
800-452-3320 x2337

Options for Financial Assistance

We want to make sure you receive the health care you need regardless of your ability to pay. Any of these options can help if you or a family member is uninsured or if you have a balance to pay after your insurance company has paid its portion.

Financial Help Available:

Price Estimates
We can provide you with estimates of charges for our services. The actual charge may be more or less than the estimate depending on the type and extent of care that you and your provider determine is needed. All of our usual and customary charges for our services are contained in our “charge master.” Your charges will depend on the actual services rendered, not on the estimate.

What is covered
Providence financial assistance is available to cover medically necessary services provided by Providence Health System in Washington, including hospital care, outpatient services, and emergency room services. If you need help paying your medical bills, we have financial counselors available to assist you with the easy process of:

Reviewing the eligibility criteria
Completion of the Application
Verification of financial need
Review of other payor sources available, i.e. local, state and federal health care programs.
This program is intended for patients who cannot afford or do not qualify for health insurance, and/or have very limited financial resources, or who have incurred sizable medical bills that are beyond their ability to pay.

Any patient can apply for financial assistance with medical bills. Eligibility will be determined based on your household income, monthly expenses, available assets, current financial obligations, outstanding medical bills and availability of insurance coverage. You will be asked to provide this information on a Financial Assistance Application.

Examples of documentation that will be required are pay stubs, tax return forms, bank statements, and medical bills owed.

Uninsured patients earning up to 400 percent of the federal poverty level are eligible for financial assistance. Other patients, regardless of insurance coverage, who are experiencing financial hardship are encouraged to apply for assistance and will be considered on an individual basis. (See our Charity Care Policy)

If you have insurance or are covered under Medicaid or Medicare, please share that information with our financial counselors when you seek care at Providence hospitals. This will help them better assist you.

Download our Financial Assistance Application

The following programs are available:
Financial Assistance / Charity care*
Discounts for uninsured patients
Prompt Pay Discount
Alternative payment arrangements.
You may qualify for financial assistance for hospital bills paid within the last 6 months. We want to make sure you receive the health care you need regardless of your ability to pay. A list of Providence free-standing and provider based outpatient clinics, is available upon request from our Providence Financial Counselor.

* Charity care does not include bad debt or limits of coverage from government programs, but may include insurance co-payments, deductibles or both.

Government and community programs
No single organization can meet the needs of all patients who are unable to cover their medical bills. For this reason, patients without insurance coverage must take advantage of all programs for which they are eligible. This helps ensure that Providence resources will be available to patients who don’t qualify for other financial help.

A Providence financial counselor will work with you to determine eligibility for government and community programs that may help cover medical expenses. The counselor can also assist you in applying for these programs.

Payment plan options
After all available health insurance coverage, financial assistance and discounts have been applied to your medical bill, there may still be a remaining balance. Providence financial counselors can work with you to set up a payment plan for this amount.

To ask about setting up a payment plan, please contact a financial counselor:
Saint Mary Medical Center
509-522-5804
800-452-3320 x2337
Payment is due within thirty days after you receive notification of your outstanding balance. Providence accepts the following forms of payment:
Credit card and Debit card (American Express, Visa, MasterCard, Discover)
Personal Check
Money Order
Cash – when presented in person

Billing FAQ

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What will I need to pay?

Most major insurance companies require patients to pay a deductible. After the deductible is met, your insurance company usually pays a percentage of the costs of service.

The amount of the bill that you must pay will depend on your insurance policy. If you have questions about your benefits, contact your insurance company directly.

Whom do I contact if I have questions about my bill?

Please contact our Customer Service Department at 1-866-356-6658.

How do I contact my insurance company?

You will find a customer service phone number on your insurance card, usually on the back.

Will you bill my insurance company?

If you have provided health insurance information we will file an insurance claim for you. Usually a claim is paid within 30 to 60 days after being submitted to the insurance company. In cases where there are two insurance companies to bill, the second insurance will be billed after the first insurance has paid.

How is my hospital bill determined?

We determine your hospital bill on the length of your stay, the type of room, and the hospital services and medications ordered by your physician. You will be billed separately for the services of your physician, emergency room physician, consulting physician, or other professionals.

Payments FAQ

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How can I find out when and where my last payment was applied?: Contact Customer Service to request an itemization of your accounts.

Category: Payments

Medicare FAQ

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What is an Advance Beneficiary Notice (ABN)?

An ABN is a written notice that you may receive from physicians, providers, or suppliers before providing a service or furnishing an item to you. The ABN notifies you:

That Medicare will probably deny payment for that specific service or item.
The reason the physician, provider, or supplier expects Medicare to deny payment.
That you will be held personally responsible for payment if Medicare denies payment.

I disagree with a Medicare claims decision. How do I request an appeal?

Photocopy your Medicare Explanation of Medicare Benefits form.
Write on the Explanation of Benefits (EOB) form, "Please reconsider for payment. My doctor ordered this service.” If possible, contact your physician and ask for additional information to submit with the EOB. An example of additional information would be a letter from your physician explaining why the test was ordered.
Mail your appeal to:

Medicare Northwest
PO Box 30270
Salt Lake City, UT 84130

What are the Medicare deductible, coinsurance and premium rates for 2008?

Part A:

Deductible:
$1024.00 per benefit period
Coinsurance:
$256.00 a day for days 61-90 in each period
$512.00 a day for days 91-150 for each "Lifetime Reserve" day used
$128.00 a day in a skilled nursing facility for days 21-100 in each benefit period
Premium:
$423.00 per month for those who must pay a premium
$465.30 per month for those who must pay both a premium and a 10% increase
$233.00 per month for those who have 30-39 quarters of coverage
$256.30 per month for those who have 30-39 quarters of coverage and must pay a 10% increase

Part B:

Deductible:
$135.00 per year
Coinsurance:
20%
Premium:
$96.40 per month