Insurance and billing

Everyone’s insurance is different, so ask your insurer about your plan. Is SCCA in your network? Are there deductibles or co-payments that you will have to pay yourself? The amounts will be lower if SCCA is in your health plan’s network.

Ask your insurance provider if your health plan contracts with the organizations that would provide your care here: SCCA, University of Washington Physicians (the practice group for the doctors who will take care of you), UW Medicine, and Seattle Children’s.

In response to the potential growth of COVID-19 cases. The Washington Health Benefit Exchange announced a limited-time special enrollment period for qualified individuals who are currently without insurance that will allow uninsured individuals an opportunity to enroll in health insurance coverage through Washington Healthplanfinder.

Special Enrollment Period to extend the timeframe for Enrollment

The Washington Health Benefit Exchange (WAHBE) is aligning with the federal marketplace (Healthcare.gov) to provide additional time for people to enroll in health insurance. In support of this effort, the Exchange will be replicating federal flexibility and provide a special enrollment period (SEP) to extend the timeframe for Washingtonians seeking health coverage. 
 
We realize that extraordinary times call for extraordinary measures. Aligning with federal efforts to extend the time for individuals to secure health coverage is a necessary step to ensure the ongoing health, safety, and well-being of Washingtonians during the current pandemic.
 
What you need to know:

• This SEP begins on February 15, 2021 and runs through August 15, 2021.
• This SEP is for those currently uninsured as well as those who are enrolled in other health insurance products – including short-term limited duration plans, health sharing ministries or COBRA – who are seeking coverage alternatives (anyone not currently covered through Washington Healthplanfinder).
• Current Washington Healthplanfinder enrollees are not eligible and may not change plans (this does not apply if an enrollee experiences a qualifying life event that allows for a plan change).
• Individuals have 60 days from the date the SEP is approved to enroll in and submit their plan selection.
• Enrollment follows the 15th of the month rule. For example: 
  • Enrollments that occur before the 15th of the month will have a coverage start date of the first day of the following month. 
  • Enrollments after 15th of the month will have a coverage start date of the month after the next month – the second following month.

Go to Washington Healthplanfinder

• Anyone enrolling through April 8, 2022 will have coverage effective April 1, 2022
• Anyone enrolling from April 15, 2022 to April 31, 2022 will have coverage effective May 1, 2022

In addition, current Washington Exchange enrollees with income changes due to:

• Reduction in work hours during the COVID-19 state of emergency
• Loss of employment

You can report income changes at any time during the plan year. Based on the income change you may be eligible for increased subsidy assistance to pay for Washington Health Benefit Exchange premiums.  Also, based on income and citizenship status, you may qualify for Washington Apple Health Medicaid which provides healthcare at no cost. More information is available here.

Individuals seeking special enrollment or to request a change can:

• Contact Washington Healthplanfinder Customer Support Center 7:30 am to 5:30 pm Monday through Friday at (855) 923-4633; TTY: (855) 627-9604. Language assistance and disability accommodations are provided at no cost
• Contact a local certified broker
• Contact SCCA Patient Financial Services at (206) 606-6226 or toll free at (800) 304-1763
• Read more information on Washington Healthplanfinder here

Many people seeking insurance through Washington Healthplanfinder will not have in-network coverage for cancer treatment at SCCA. Because this may affect you and your family’s out-of-pocket cost for care, we want to give you information to help you understand your care options during the open enrollment period from November 1, 2021 - January 15, 2022.

• SCCA is an in-network provider for the following health care plans: Molina Marketplace, Premera Blue Cross, Kaiser Foundation Health Plan of WA*, LifeWise Health Plan of Washington (Preferred Plan), and BridgeSpan (UW Medicine). *Specialist services are covered, pending permission to see a specialist

A Financial Coordinator can assist you with understanding your insurance benefits. Call (206) 606-6226 or toll-free at (800) 304-1763 and ask to be transferred to a Financial Coordinator. Or, contact your SCCA clinic scheduler to arrange an appointment with a Financial Coordinator.

If you are receiving a stem cell or bone marrow transplant, you can schedule a meeting with Patient Financial Services as part of your pre-transplant consultation. 

To find out the estimated charges of a recommended treatment plan, call (206) 606-6226.

Many insurance companies limit payments to "usual, customary, and reasonable" (UCR) fee schedules. Our charges may differ from insurance companies' UCR allowances; you are responsible for payment regardless of your insurer’s UCR limits.

Health insurers often require pre-authorization for certain services, including CT, MRI, and PET imaging; chemotherapy; radiation therapy; and bone marrow transplants. We will work with you to get pre-authorization from your insurance carrier for services we provide. However, this may not be possible if services are ordered and provided in less than a 48-hour window.

In those situations, we recommend that you contact your insurance carrier for pre-authorization. If your insurance company fails to pay due to lack of pre-authorization, you will be financially responsible for payment.

Contact your primary care doctor’s office for a referral to SCCA if your insurance plan requires a primary care provider referral before you can be treated here.

If you don’t have insurance, an SCCA financial counselor will work with you to find out if you qualify for financial assistance or Medicaid, a jointly funded, federal/state health-insurance program for low-income people.

SCCA directs patients without insurance to their state-specific Health Care Exchange. Washington residents can use Washington Healthplanfinder to choose a plan based on cost, coverage, convenience, or any other factors that are important to you. Under the federal Affordable Care Act, insurance companies cannot deny coverage to people with existing conditions.

Go to Washington Healthplanfinder

Coverage for treatment received as part of a clinical trial varies among health insurance companies. For Medicare beneficiaries, treatment received in clinical trials is covered, with some restrictions. If you have questions, call (206) 606-6226 or toll-free at (800) 304-1763.

Financial assistance is available to Washington residents based on family need and SCCA resources. An SCCA financial counselor can help you with the applications for financial assistance or public insurance programs such as Medicaid. These programs may help you with your current and future health care bills. Please ask your scheduler for an appointment with a financial counselor or contact one directly at (206) 606-6226 or toll free at (800) 304-1763.

Which insurance plans on Washington Healthplanfinder include SCCA?
SCCA is an in-network provider for the following health care plans: BridgeSpan  RealValue Network, Kaiser Foundation Health Plan of WA*, Kaiser Foundation Health Plan of the Northwest*, Premera Cascade Care Blue Plan (Individual Signature) , Regence Cascade Care Individual and Family and United Health Care Cascade Care (Gold, Silver and Bronze) Plans.
*Specialist services are covered, pending authorization from Kaiser oncologist

What do I do if I am told that my new insurance coverage does not cover my current treatment and care at SCCA?
If your new insurance coverage through Washington Heathplanfinder places SCCA as an out-of-network provider, this may affect your out-of-pocket costs for cancer care. Because each case is unique, it’s important to contact your insurance company to discuss your options. Additionally, our Patient Financial Services team is available discuss options for continuing your care with us. Patient Financial Services is available Monday through Friday from 7:30 am to 4 pm at (206) 606-6226 or toll free at (800) 304-1763.

Can I still have treatment at SCCA?
We are committed to providing the best cancer care to all who come to us. However, your individual circumstances and benefits plan may change your coverage, increasing your out-of-pocket costs. To best understand how this change impacts you, we encourage you to contact your insurance company to discuss how your out-of-pocket costs might change. 

Does this impact my SCCA treatment at SCCA at UW Medical Center - Northwest/SCCA at EvergreenHealth?
Changes to your insurance coverage may impact your out-of-pocket costs at these sites. To best understand how this change impacts you, we encourage you to contact your insurance company. 

How can I be certain that my doctor is covered by my insurance while I am treated at SCCA?
The best way to understand your coverage is to contact your insurance company and ask them specifically about your doctor. SCCA Patient Financial Services is available to assist you in those conversations as needed. 

What if I have already begun my treatment at the SCCA? The continuity of my care is important to me. Can someone help me advocate for coverage after my insurer has declined payment?
It is important to contact your insurance company early to fully understand any changes to your coverage. Each insurance plan has a different set of criteria regarding continuity of care. 

Will the new insurance company notify me of any changes to coverage? What recourse do I have when I find out my coverage has changed without being notified? 
Your insurance company should contact you about any updates. When discussing any changes, it is important to know details concerning both your provider network as well as benefits plan. Use the following questions as a guide when talking with your insurance company:

• What health care facilities and doctors are considered “in network”?
• What health care facilities and doctors are considered “out of network”?
• What are my out-of-pocket responsibilities for both in-network and out-of-network health care providers?

Who do I contact if I have additional questions?
We recommend that you first call the number on the back of your insurance card in order to understand directly from your insurance company what types of care they now cover. If you have concerns about how you can pay for your care or need any additional assistance, please call Patient Financial Services.

How do I contact SCCA Patient Financial Services with questions or concerns?
Patient Financial Services is available Monday through Friday from 7:30 am to 4 pm at (800) 304-1763.

SCCA participates in most national private health insurance plans and Medicare, the federal health insurance program for people who are age 65 and older or who are disabled. We also participate in Medicaid insurance for patients from Washington, Alaska, Montana, and Idaho.

You can help us bill your insurance company correctly by providing full information to SCCA Registration and Patient Financial Services when you register. It is important to inform us of any changes to your address, insurance coverage, or employment of the person who is financially responsible for your bills.

When an insurance claim is pending, you will still receive a bill each month if your account has an unpaid balance. You are responsible for payment of your account within the limits of our credit policy (see below).

Depending on your insurance, you may be responsible for a copayment or coinsurance. The amount will depend on the services provided and your insurance coverage.

Payments are due within 30 days after you receive your SCCA, UWMC or UW Physicians bill. If you are unable to pay in full, please contact the appropriate billing office to make payment arrangements. It is important to do this soon after receiving your statements until your account is paid in full, regardless of whether or not you have insurance coverage.

How do I view my monthly statement and make payments online?
In order to view your monthly statement and make payments online, you must enroll by entering your Medical Record Number and Patient Name (as reflected on your monthly statement).

What is an Encounter Number?
The Encounter Number corresponds to the number that's printed on your paper statement.  It begins with the number 6 and is an eight digit number (example: 69999999). You will have a different encounter numbers for each date of service you are seen at SCCA.

What is a Medical Record Number?
The Medical Record Number is the number that's printed at the top of the first page of your paper statement under Patient Name. It is a seven digit number. This is the account number used to access your overall account. 

Can another family member access my online account?
A family member can only access your account if you choose to provide that person with your Medical Record Number and password.

Can I still receive my monthly paper statements if I sign up for e-Statements?
No.  During the enrollment process, you will be asked if you would like to receive your monthly statements online only, or continue receiving your statements through the mail. Once you elect to receive you monthly statements electronically, you will no longer receive them in the mail. You can always go back to paper by going to your patient profile in the 'My Account' section to change your preference.

Will I continue to receive paper itemizations if I sign up for e-Statements?
No.  Itemizations are not included with the billing statements but are available upon request by calling 800-304-1763 or emailing ptacct@seattlecca.org.

Can I contact the Patient Accounting office through e-mail?
Yes, you may e-mail our office at ptacct@seattlecca.org 24 hours a day, seven days a week with questions. You will receive a response from us within two business days.

Can I make payments online without enrolling?
Yes. Please have the Patient Name and Medical Record Number, as indicated on your paper statement, and follow the quick pay instructions.

Will I be able to pay online for multiple visits?
Yes.  Please select the visits you would like to pay.

Will I be able view and pay my physician statements from this site?
No, only your Seattle Cancer Care Alliance statements will be available from this site.

Do I need to establish an electronic payment method to be eligible for the online account manager?
No. When it comes time to pay your bill, you will have the option to either establish an electronic payment method or print a payment stub out on your home printer.

What specific type of electronic payment method can I use?
You can make payment electronically, via credit card, or debit card.

Can I print my monthly statement and mail my payment instead of paying electronically?
Yes. You have the option of printing your statement and mailing the payment stub with your check or credit card information. Just click the 'Print Payment Stub' option on the 'Make Payment' page.