Payment Options

Our financial counselors can guide you through the billing process by answering insurance questions, offering financial counseling, and assisting with payment plans for medical bills.

Our priority is that our financial assistance, Charity Care, and collections processes be fair, reasonable, and legally compliant with both State and Federal laws in a manner that is both respectful and effective.

  • Mail: to Jefferson Healthcare, Financial Services Office, 834 Sheridan, Port Townsend, WA 98368
  • Telephone: Call 360.385.2200 extension 2267 or 855.581.LINK (5465)
  • In-person: The Financial Services Office is located at 803 West Park Avenue, open 9:00 a.m. to 4:30 p.m.

Insurance Carriers Contracted with Jefferson Healthcare

Always confirm assigned PCP with your insurance carrier prior to scheduling primary care services.

Please contact your insurance plan to verify whether Jefferson Healthcare is considered in-network for your policy. If Jefferson Healthcare is not in-network and your policy includes out-of-network benefits, you may still be able to receive covered care with Jefferson Healthcare as long as your plan authorizes the services. If Jefferson Healthcare is out-of-network-, all non-emergency services will require prior authorization from your insurance carrier, including visits to the Express Clinic, as it is not an Urgent Care facility. Please check your policy, as services provided outside your plan’s network may have a higher out-of-pocket cost.

MEDICARE INSURANCE PLANS ACCEPTED BY JEFFERSON HEALTHCARE

  • Medicare Part A & B
  • Molina Medicare + DUAL (D-SNP) Plans
  • CHPW Medicare + DUAL (D-SNP) Plans
  • Regence Medicare Advantage

MEDICAID INSURANCE PLANS ACCEPTED BY JEFFERSON HEALTHCARE

  • WA State Medicaid/Apple Health
  • Molina Medicaid/Apple Health
  • CHPW/Apple Health (Community Health Plan of WA)
  • Coordinated Care/Apple Health
  • United Healthcare Medicaid
  • Wellpoint Medicaid (Formerly Amerigroup)

WA HEALTHCARE EXCHANGE (Bronze, Silver and Gold) ACCEPTED BY JEFFERSON HEALTHCARE

  • Community Health Plan of WA (CHPW)
  • Coordinated Care (Ambetter) Cascade plans
  • LifeWise
  • Regence Blue Shield
  • United Healthcare

OTHER COMMERCIAL INSURANCE PLANS ACCEPTED BY JEFFERSON HEALTHCARE

  • Aetna
  • Ambetter
  • Community Health Plan of WA (CHPW)
  • Coordinated Care
  • Cigna
  • First Choice Health
  • Molina Healthcare
  • Premera Blue Cross
  • Regence Blue Shield
  • Sound Health
  • Tricare (HealthNet)
  • TriWest VA
  • United Healthcare
  • WA Labor & Industries
  • VA Community Care

Further Information

In late 2018, Jefferson Healthcare conducted a complete pricing study to ensure alignment with similarly sized hospitals. The study identified several areas for adjustments to be more competitive while continuing to be viable and to enable reinvestment in community care.

•             How are prices set?

Jefferson Healthcare sets prices comparable to other hospitals in the area and considers the resources needed to provide each service. Resources include staffing, time, equipment and materials used for service. Jefferson Healthcare reviews every line of the Chargemaster (list of charges with corresponding procedure codes) to ensure prices are comparable, match the complexity of the service and correspond to the resources needed to provide the service.

•             Where were the biggest adjustments made?

The most significant downward adjustments were made to diagnostic imaging (x-ray, CT, MRI, and ultrasound), laboratory tests, and respiratory therapy.

•             How will this impact the overall hospital budget?

The hospital budget for 2019 included these price decreases. Through the budget process, the hospital identified ways to find savings or grow other programs that would offset these costs.  Additionally, there were a few areas where prices were below market; these have been adjusted (though to a much smaller degree than the decreases).  Overall, this will affect the overall budget by a decrease in contractual adjustments because a significant portion of our reimbursement is contingent on factors other than price.

•             Will these changes affect my care?

Absolutely not.  Jefferson Healthcare continues investing in services and programs with excellent staff and equipment to ensure the highest level of care.  The hospital has identified ways to offset these reductions without affecting staffing or any other components affecting our patients’ care.

•             What is a Chargemaster?

The Chargemaster is the complete list of prices across all departments and service lines.  This list includes procedure codes for care and the price per unit.  Some units are obvious (per visit, per procedure), while others are based on diagnosis or a less straightforward unit (minute per surgery, duration of recovery).

•             Can this list of prices be used to get an estimate?

The list is a valuable tool for understanding prices, though most services involve a combination of prices.  Understand that in many cases, it is impossible to predict final charges because of variables that affect services.  Please contact our Financial Counseling office at 360-385-2200 ext 2267 for an estimate to ensure all components are considered.

•             How is patient financial responsibility calculated?

Patient responsibility varies by the payor and can include copays, coinsurance, or other patient responsibilities.  Insurance companies determine the portion of the bill the member is responsible for, and the Jefferson Healthcare Financial Counselors team is available to help you understand these terms.

•             What other hospitals are considered relevant for comparing prices?

Jefferson Healthcare looked at Olympic Medical Center and Harrison Medical Center, given their proximity.  Several hospitals in the Seattle area (including Harborview, Overlake, Providence Everett, Swedish First Hill, University of Washington, and Virginia Mason) and two hospitals in the Tacoma area (St. Josephs and Tacoma General Hospital) were considered in the analysis as well.

•             How do property taxes affect pricing?

As a public hospital with very low tax support compared to other public hospital districts, it is important to set prices at a sustainable level to ensure very important services to our community are maintained.  Jefferson Healthcare does not go above the median of the market to achieve this priority; as a result, rates have been reduced in several areas to meet this objective.

•             Are prices different at different Jefferson Healthcare locations?

Jefferson Healthcare works to keep prices the same across different settings, although billing requirements result in variances in how these services are billed. Services are priced the same, though they may be broken into two components in specialty clinics.

Jefferson Healthcare is a partner to help patients understand the prices and potential patient responsibility.  Questions and/or concerns can be directed to the Financial Counseling team at 360-385-2200 ext 2267

You have the right to request an estimate of potential charges prior to receiving any medical service. Estimates may vary based on the complexity of your medical condition and any deviations from the initial care plan as determined by your provider. To request an estimate, please call 855.581.LINK (5465) for more information.

After your visit and your insurance company has reviewed your claim, a statement from Jefferson Healthcare will be mailed to you. Payment in full is due at this time. Please contact us to discuss your options if you cannot pay in full. You will receive three reminder statements and a final notice before being referred to a third-party agency if you have not paid. Prior to being referred to a third-party agency, a financial counselor will attempt to call you.

Beginning January 1, 2020, Washington state law protects you from ‘surprise billing’ or ‘balance billing’ if you receive emergency care or are treated at an in-network hospital or outpatient surgical facility.  Read more about this law: Balance Billing Protection Act.

Jefferson Healthcare contracts with other providers to help meet your care needs. These companies represent anesthesia, laboratory, radiology, sleep medicine, urology, etc. If you have questions about these companies, please contact the Financial Services Office.

We must make a reasonable effort to collect on accounts that are due. We do not harass patients for payment or use collection agencies that use pressure tactics. Any patient who states that he or she does not have the means to pay a bill will be referred for financial counseling to determine eligibility for one of the helping programs. We base our charging methodology on the American Medical Association’s standard procedural terminology codes to ensure consistency and fairness throughout our system. Our charges are in the mid-range for rural hospitals. We realize that hospital charges are increasing and the health care system is complex. Therefore, we have made a significant effort to ensure that access to needed care is available. If you have more questions, please call us at (360) 385-2200 ext. 2267.

Jefferson Healthcare offers a variety of alternative payment options, including:

  • Prompt pay discounts
  • Interest-free payment plan arrangements
  • Financial Assistance, which includes Charity Care and Sliding Fee Scale supported by Washington State Law

Jefferson Healthcare is committed to providing healthcare services to all people who are in need of medical attention, regardless of their ability to pay.  To learn more about applying for financial assistance, please visit our Charity Care Page.

Podcast

Jefferson Healthcare Patient Access team continues to work with patients to maintain coverage and help guide them through the billing process by answering insurance questions and answering financial counseling.

In our podcast To Your Health as Damon McCutcheon, Manager of Patient Access shares information, tips, and strategies on Unwinding Apple Health.

Listen Here

El equipo de Acceso de Pacientes de Jefferson Healthcare continúa trabajando con los pacientes para mantener la cobertura y ayudarlos a través del proceso de facturación al responder preguntas sobre seguros y brindar asesoramiento financiero.

Escuchar en Español

Local Resources

DSHS Community Services Office
p) 877.501.2233
www.dshs.wa.gov

Jefferson County Public Health
p) 360.385.9400
www.jeffersoncountypublichealth.org

Washington HealthPlanFinder
p) 855.923.4633
www.wahealthplanfinder.org

Healthcare Authority
p) 360.385.2200 ext. 2265
www.hca.wa.gov