You may get more than one statement for the services you receive. To meet federal and state billing regulations, we must classify the cost of many services into these categories:

• Providers
• Staff
• Supplies

This can result in multiple, separate billings for a single date of service. It also means you might receive more than one explanation of benefits from your payer and more than one statement. Common examples include:

• Inpatient hospital care plus a doctor’s services
• Outpatient X-ray exams plus radiologist services
• Emergency department treatment plus emergency physician’s services
• A doctor’s office visit plus lab or X-ray services

Fees and charges are based on our “charge master” rates. Fees and charges for services at a private physician clinic may differ from those at a clinic owned or operated by a Providence hospital. You can get a complete list of Providence clinics by calling Customer Service at 1-866-747-2455.

Pay My Bill

Working together, we can keep the billing process as simple as possible. To help us do a better job, please:

• Tell us about your health insurance or coverage by government programs, such as Medicare, when you register for services.
• Become familiar with your insurance benefits so you’ll understand how much will be covered by insurance and how much you’ll be responsible for. (If you have questions about your insurance coverage, please call your insurance carrier directly.)
• Have your co-pay ready at the time of service.
• Let us know immediately if you expect to have trouble paying your bill.
• Pay your bill on time.

If you have a question about a bill from another provider – such as a surgeon, radiologist, anesthesiologist or other specialist – be sure to call that provider directly.

• Co-payments are due at the time of service. We accept cash, personal checks, Visa, MasterCard, American Express and Discover Card.
• If there’s still a balance after we bill your insurance, we’ll send you a bill within 30 days.
• We don’t charge fees for late payments or credit card payments made over the phone. Our payment plans are interest free.
• We accept most local and many national insurance plans, including Medicare.
• You’re responsible for understanding whether your insurance has restrictions on the doctors you can see or health services and procedures you receive.
• If your insurance plan requires your primary care physician refer you to a specialist, the referral must be received prior to the scheduled appointment with the specialist.
• If you provide complete and accurate information about your insurance, we will submit claims to your insurance provider and receive payment for services.
• Depending on your insurance coverage, you may be responsible for co-payments, co-insurance or other deductible amounts.

• Firearms and pets (other than service animals) are not allowed at our clinics.
• Soliciting products or information on Providence property is strictly prohibited.
• If you fail to comply with any Providence policy – either stated here or at the clinic – you may be asked to leave the premises.
• Canceling an appointment: If you need to cancel an appointment, please give us 24 hours notice.
• Tobacco free: All Providence Medical Group clinics are tobacco free. Using tobacco of any kind is strictly prohibited on Providence Medical Group campuses, in vehicles owned by Providence and in vehicles parked in parking lots or garages owned by Providence. Smoking is the leading preventable cause of death in the United States. Providence has a responsibility to encourage and promote healthy lifestyles in our community. It is consistent with our mission.
• Notice of privacy practices describes how your medical information may be used and disclosed and how you can access this information. Review the Providence notice of privacy practices.
• There are a number of ways your medical information may be used without your authorization, either because they are required by law or for public health and safety purposes. Learn more about rights with respect to your medical information we maintain.