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Insurance Information

Northwest Medical Specialties accepts most major insurance policies including the following:

  • Aetna – all commercial plans
  • Cigna/Most Plans
  • First Choice Health Network
  • Medicare Part B
  •  Secure Horizons, Secure Horizons Medicare
  • Advantage and Secure Horizons Direct
  • Molina
  • Premera Blue Cross Blue Shield
  • Regence Blue Shield, Regence Selections
  • Boeing Selections, Boeing Traditional
  • Tricare/Champus
  • United Healthcare

Other Insurance policies may also be accepted. Please call (253) 428-8700 for more information.

Insurance Cards

Please bring all of your insurance cards (primary, secondary and tertiary) to every appointment and notify your physician’s office immediately if there are any changes to your insurance. We collect co-payments at the time of service.

Understand Your Plan

Each insurance policy is different, so take the time to understand your plan. The amount of coverage your plan provides varies depending on: your insurance company, your healthcare benefits package and your specific plan. For additional information, contact your plan directly.

To obtain the details of your policy, contact the Customer Service or Member Services Department at your insurance company. The phone numbers are on your insurance card or in your benefits book. They will be able to tell you about your in-network and out-of-network coverage for care and what your financial responsibility will be. Many insurance companies limit payments to medical providers using their own fee schedule of usual, customary and reasonable rates, so ask about this.

Questions to Ask Your Insurance Company

What type of insurance plan do I have?

Your insurance company might tell you that you have one of the following plans:

  • Health Maintenance Organizations (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Exclusive Provider Organizations (EPOs)
  • Point of Service (POS) and indemnity insurance plans

Is Northwest Medical Specialties in my network?

If so, here are some follow-up questions to ask:

  • Does my insurance plan cover all my physician costs as well as diagnostic testing performed in my physician’s clinic?
  • What, if any, are my co-payments?

What if Northwest Medical Specialties is not in my network, but my plan has out-of-network benefits?

If so, here are some follow-up questions to ask:

  • If I choose to go out-of-network, what do I have to pay?
  • What is the amount of my deductible?
  • If I go out-of-network, what percentage of my bill will be paid by the insurance company?(Examples: 80 percent paid by insurance/20 percent paid by patient, 70/30, 50/50, etc.)
  • Is the percentage of my bill paid by the insurance company based on usual, customary, and reasonable (UCR) schedules or on the actual charges?
  • Does my policy have an out-of-pocket maximum? (This is the maximum amount that you are required to pay toward the cost of your care.)
  • If my out-of-pocket expenses reach a certain amount, will the insurance carrier ever reimburse at 100 percent?
  • If so, does this mean that my claims will then be paid in full, or will I still be responsible for the difference between Northwest Medical Specialties, PLLC charges and usual, customary, and reasonable (UCR) rates?
  • Before I see a doctor with Northwest Medical Specialties, PLLC, do I need a referral from my primary care physician, or will I need authorization from my insurance carrier?
  • Will I be covered for any testing, pathology, or radiology charges that may be incurred as part of my care from Northwest Medical Specialties, PLLC?

Be sure to make note of the name of the person you talked to and the date you spoke to them.

HEALTH ALERT! For the safety of our patients and staff only patients will be allowed into our clinics and everyone MUST wear a mask. See additional information regarding the Coronavirus (COVID-19).

COVID-19 NOTICE

Important COVID 19  Information for patients of Northwest Medical Specialties

November 16, 2020 Update

IMPORTANT: NO VISITORS
During these difficult times we are making every effort to keep our patients and staff safe from COVID 19, we appreciate your patience and understanding with the changes you may have seen within our practice.

We strive to protect our patients and staff as much as we possibly can from any exposure on our premises.  NWMS has implemented a system wide policy that does not allow anyone in the building that is not a patient and everyone must wear an NWMS provided mask over their mouth and nose during their time on our premises.  This is to protect our vulnerable patients from the unforeseen possibility of exposure to COVID 19 which can be transmitted through aerosol droplets.  Sadly, we have had patients that have died from the complications of COVID 19, which is both devastating and preventable.

We offer a virtual visit option for family, friends, and companions to participate in the care of our patients through Zoom.  Our staff will assist you with every step of the login process and invite you to participate in real time from your vehicle or designated safe space in our building. Please contact us at 253-428-8700 to set this up.

The following offices are temporarily closed:

If you are experiencing cold or flu symptoms, please make sure to contact us via phone prior to your appointment. You may also contact us for any additional questions by calling our office at (253) 428-8700.

Here are a few additional resources as well:

World Health Organization

Centers for Disease Control