Billing

You can contact the Billing Department at 360-452-6252, option 9.

Office Hours: Monday–Friday, 8:00 AM–4:00 PM.

Yes.

Please tell registration staff about your Tribal/IHS eligibility and provide applicable information requested by the health center.

This helps us determine what coverage or billing requirements may apply to your care.

Please provide:

 Proof of enrollment or CIB

 Descendants, please provide Birth certificate with parent’s proof of enrollment or CIB

 Insurance information

 If you do not have insurance, we need proof that you applied per Resolution 10-2000 from the Lower Elwha Tribal Council-        Instituting a Requirement that Patients and Clients of Tribal Health Programs Apply for Alternate Resources

The Lower Elwha Health Department accepts Medicare, Medicaid, and most private insurance plans. We recommend contacting your insurance company to confirm that Lower Elwha is an in-network/preferred provider

Lower Elwha Health Department accepts all major health insurance plans. CHM is a health care sharing ministry and is not considered health insurance under Washington State law (RCW 48.43.009). Therefore, CHM members are considered self-pay patients.

Yes. Our Billing Department can provide you with an itemized statement that you may submit to CHM for consideration under your membership guidelines.

Under RCW 48.43.009, health care sharing ministries are not classified as health insurance carriers or insurers in Washington State. For this reason, CHM is handled as a self-pay arrangement rather than traditional insurance billing.

Payment is due at the time of your appointment, unless you have made other payment arrangements with our Billing Department.

The billing department does not submit claims for LabCorp. Since LabCorp is an outside laboratory, they handle their own billing and insurance claims.

If you receive a bill from LabCorp or have questions regarding a billing issue or denied claim, please contact LabCorp directly for assistance.

You may also call 360-452-6252, option 1, to leave a message for your provider’s Medical Assistant regarding your LabCorp bill.

We ask for your insurance information so we can bill your health plan for covered services. Providing current information helps prevent delays, incorrect billing, and unexpected balances.

Please provide:

Changes to your insurance coverage

Insurance card

Member or identification number

Group number, if applicable

Medicare information

Medicaid/Apple Health information

Other insurance information

Please bring your current insurance card whenever possible. Your coverage can change, and we may need to verify your eligibility.

Please tell our PSR staff that you do not have insurance. We can explain our Sliding Fee Discount Program, financial assistance, and payment options for which you may qualify.

Please notify us as soon as possible. Give us your new insurance card and effective date if available.

If we have outdated insurance information, your claim could be delayed or sent to the wrong insurance company.

Our staff can help you apply through Washington Healthplanfinder Marketplace for available coverage.

You may receive a bill when there is an amount remaining after insurance has processed your claim.

Your balance may result from:

• A copayment
• Deductible
• Coinsurance
• A non-covered service
• An insurance denial
• No insurance coverage
• Other patients responsibility is determined by your health plan

If you are unsure why you received a bill, please contact us or your insurance company before making payment.

Your insurance may have paid part of the claim and assigned the remaining amount to you. Your Explanation of Benefits (EOB) can help explain how your claim was processed.

An EOB is a statement from your insurance company explaining how a claim was processed.

It may show:

• Amount billed
• Amount allowed by your insurance
• Amount paid by insurance
• Amount not covered
• Amount assigned to patient responsibility

An EOB is generally not the same thing as a bill

Please contact us before paying.

We can review your account and explain the charges, insurance payments, adjustments, and remaining balance.

Medicare may not pay the entire cost of every service.

Depending on your Medicare coverage, you may have:

• Deductibles
• Coinsurance
• Other patients responsibility

If you have Medicaid, Tribal/IHS coverage, or another secondary insurance, please provide that information.

Yes.

Please provide information for both programs so we can properly coordinate your coverage.

Yes. Medicare Advantage plans are different from Original Medicare and may have their own network, authorization, referral, and cost-sharing requirements.

Please provide your current Medicare Advantage card.

If you have Apple Health/Medicaid and receive a bill, please contact us if you believe the charge should not be your responsibility.

Please provide your coverage information and contact us. We can review whether the claim was submitted correctly and whether additional information is needed.

Please tell us about the change. Managed care enrollment and other coverage information can affect where and how claims are submitted.