Languages Idioma
Pay My Bill
  • Española
  • Français
  • Русский
Family Health Centers
1-800-660-2129
Schedule A Visit
  • Home
  • Locations & Hours
    • Brewster
    • Bridgeport
    • Okanogan
    • Omak
    • Oroville
    • Tonasket
    • Twisp
  • Providers
    • Medical
    • Dental
    • Behavioral Health
    • Pharmacy
  • For Patients
    • Schedule a Visit
    • Patient Portal/ Pay My Bill
    • Our Services
      • Medical Care
      • Dental Care
      • Pharmacy
      • Behavioral Health
      • Naturopathic Medicine
      • Immunization
      • Children's Health
      • Chronic Care Model
      • Obstetrics & Women's Care
      • Women, Infants & Children (WIC)
      • Medication Assisted Treatment (MAT)
      • More Services
    • COVID Vaccine
    • Video Visits
    • Help with Insurance
    • Reduced Fee Program
    • FAQs
    • Information & Rights
      • Release of Information
      • Patient's Bill of Rights
      • Balance Billing Protection Act
    • Resources
    • Community Outreach
    • Patient Centered Medical Home
  • About Us
    • Privacy Policy
    • Board of Directors
    • 🔑 Board Log In
  • Careers
    • Current Job Openings
    • Loan Repayment Programs
  • Residency
  • COVID Vaccine

Balance Billing Protection Act

Know your rights under the Balance Billing Protection Act:

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.

What is ‘surprise billing’ or ‘balance billing’ and when does it happen?

Under your health plan, you’re responsible for certain cost-sharing amounts. This includes copayments, coinsurance and deductibles. You may have additional costs or be responsible for the entire bill if you see a provider or go to a facility that is not in your plan’s provider network.

Some providers and facilities have not signed a contract with your insurer. They are called ‘out-of-network’ providers or facilities. They can bill you the difference between what your insurer pays and the amount the provider or facility bills. This is called ‘surprise billing’ or ‘balance billing.’ 
​
Insurers are required to tell you, via their websites or on request, which providers, hospitals and facilities are in their networks. And hospitals, surgical facilities and providers must tell you which provider networks they participate in on their website or on request.

When you CANNOT be balance billed:

  • Emergency Services
    The most you can be billed for emergency services is your plan’s in-network cost-sharing amount even if you receive services at an out-of-network hospital in Washington, Oregon or Idaho or from an out-of-network provider that works at the hospital. The provider and facility cannot balance bill you for emergency services.
  • Certain services at an In-Network Hospital or Outpatient Surgical Facility
    ​When you receive surgery, anesthesia, pathology, radiology, laboratory, or hospitalist services from an out-of-network provider while you are at an in-network hospital or outpatient surgical facility, the most you can be billed is your in-network cost-sharing amount. These providers cannot balance bill you.

In situations when balance billing is not allowed, the following protections also apply:

  • Your insurer will pay out-of-network providers and facilities directly. You are only responsible for paying your in-network cost-sharing.
  • Your insurer must:
    • Base your cost-sharing responsibility on what it would pay an in-network provider or facility in your area and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or certain out-of-network services (described above) toward your deductible and out-of-pocket limit. 
  • Your provider, hospital, or facility must refund any amount you overpay within 30 business days.
  • A provider, hospital, or outpatient surgical facility cannot ask you to limit or give up these rights.

​If you receive services from an out-of-network provider, hospital or facility in any OTHER situation, you may still be balance billed, or you may be responsible for the entire bill.
​
This law does not apply to all health plans. If you get your health insurance from your employer, the law might not protect you. Be sure to check your plan documents or contact your insurer for more information.

​If you believe you’ve been wrongly billed, file a complaint with the Washington state Office of the Insurance Commissioner, 1-800-562-6900​.

​​MAILING ADDRESS:
P.O. Box 1340
Okanogan, WA 98840

CONTACT US
​Call and speak with a Patient Advocate
1-800-660-2129
Schedule A Visit
​Check out our social media!
Locations

  • Brewster
  • Bridgeport
  • Okanogan
  • Omak
  • Oroville
  • Tonasket
  • Twisp
Providers

  • Medical
  • Dental
  • Behavioral Health
  • Pharmacy
For Patients / Quick Links

  • Patient Portal
  • Pay My Bill
  • FAQs
  • Video Visits
  • Help With Insurance
  • Resources
  • Reduced Fee Program
  • Release of Information
  • Community Outreach
  • About
  • Residency
  • Medical Care
  • Dental Care
  • Pharmacy
  • Behavioral Health
  • Naturopathic Medicine
  • Immunization
  • Children's Health
  • Chronic Care Model
  • Obstetrics & Women's Care
  • Women, Infants & Children (WIC)
  • Medication Assisted Treatment (MAT)

Disclaimer
This website is intended to provide general healthcare information, not medical advice, and is not intended to take the place of one's own physician. View Consumer Rights.

Family Health Centers © 2022  |  ​Privacy Policy
Family Health Centers provides high quality health care services in the communities of: Okanogan, Omak, Tonasket, Oroville, Bridgeport, Brewster and Twisp.
MAILING ADDRESS:
P.O. Box 1340
Okanogan, WA 98840

Schedule a Visit

Click Here
​​Family Health Centers (FHC) provides high quality health care services in the communities of Brewster, Bridgeport, Okanogan, Omak, Oroville, Tonasket and Twisp.
Disclaimer  |  Family Health Centers © 2022  |  ​Privacy Policy
  • Home
  • Locations & Hours
    • Brewster
    • Bridgeport
    • Okanogan
    • Omak
    • Oroville
    • Tonasket
    • Twisp
  • Providers
    • Medical
    • Dental
    • Behavioral Health
    • Pharmacy
  • For Patients
    • Schedule a Visit
    • Patient Portal/ Pay My Bill
    • Our Services
      • Medical Care
      • Dental Care
      • Pharmacy
      • Behavioral Health
      • Naturopathic Medicine
      • Immunization
      • Children's Health
      • Chronic Care Model
      • Obstetrics & Women's Care
      • Women, Infants & Children (WIC)
      • Medication Assisted Treatment (MAT)
      • More Services
    • COVID Vaccine
    • Video Visits
    • Help with Insurance
    • Reduced Fee Program
    • FAQs
    • Information & Rights
      • Release of Information
      • Patient's Bill of Rights
      • Balance Billing Protection Act
    • Resources
    • Community Outreach
    • Patient Centered Medical Home
  • About Us
    • Privacy Policy
    • Board of Directors
    • 🔑 Board Log In
  • Careers
    • Current Job Openings
    • Loan Repayment Programs
  • Residency
  • COVID Vaccine