Billing & Insurance
We are committed to providing you with comprehensive orthopedic care and we want to make sure you are aware of our billing practices, including the insurances we accept and the insurance authorizations processes.
Cash is not accepted at any of the Puget Sound Orthopaedics locations.
- Co-pays and other balances can be paid by card. We accept Visa, Master Card, Discover and American Express.
- Co-payments are due at the time of service.
- Patients are responsible for the charges associated with care even when insurance benefits are in place.
We encourage you to contact the PSO billing department directly with any questions at (206) 838-7782.
Insurance
A full list of our current contracts with insurance companies and government payers can be found here.
Did you know that you can schedule an appointment without a referral from your PCP? Check out the list below to see if your insurance qualifies:
- Ambetter Coordinated Care*
- Aetna Medicare HMO/PPO*
- Bridgespan Health*
- Blue Cross Blue Shield*
- Champva*
- Cigna*
- Coordinated Care Health Options
- First Choice Health*
- Kaiser PPO*
- Lifewise*
- Multiplan EBMS PHCS*
- Molina Marketplace*
- Molina Apple Health*
- Premera Blue Cross Blue Shield
- Humana Medicare Advantage
- Regence Blue Shield*
- Retirees Welfare Trust*
- Tricare Prime
- Triwest/ VA
- Tricare Select & Reserve Select*
- Tricare For Life (Secondary to Medicare)*
- United Healthcare*
- United Medicare Pro*
- United Medicare Complete CMG
- United Medicare OCN
- United Medicare AARP*
- US Family Health*
- Wellpoint (Formally known as AmeriGroup)*
*No PCP Referral Required for most plans
We do not contract with the following insurance companies:
- Community Health Plan of WA
- Coventry
- Humana commercial products
- Kaiser Core HMO and Medicare Advantage
- PacMed Clinics/ US Family Health Plan
- United Community Plan (United Medicaid)
- United Health Care Blind and Disabled
- United Community Plan (United Medicaid)
Note: Clinics referring patients with any insurance that we are not contracted with must begin the insurance authorization process directly from the clinic.
Insurance Authorizations
Special Testing Authorizations
Special testing includes MRI, bone scan, doppler studies, joint and spine injections, CT/CAT scans, DEXA scans, ultrasound, and EMG. Insurance processing times vary depending on your insurance. If you have not been contacted within the estimated time frame, then contact your scheduler. Review our Special Testing Notification for more information.
Surgery Authorizations
We will obtain the surgery authorization for you from your insurance, whether you are having surgery at our outpatient facility, Puget Sound Surgery Center, or at the hospital. Insurance processing times vary depending on your insurance. Review our Surgery Scheduling Checklist for more information.
Online Bill Pay
- The bill pay portal is on Proliance Surgeons website, whom we are affiliated with.
- Make separate payment transactions for Puget Sound Orthopaedics and for Puget Sound Surgery Center. Each facility statement has a different account number and multiple account numbers cannot be paid on the same transaction.
- You will need your account number located on your statement to process the payment.
- For security purposes, we are not able to take payments over the phone.
Financial Assistance
At Proliance Surgeons, we believe everyone should be able to access the care they need, regardless of their ability to pay. That’s why we offer a Financial Assistance Program to help patients who qualify to receive care at no cost or a reduced cost.
Who can apply? You may qualify if:
Your care was medically necessary (not elective or cosmetic).
You do not have insurance — or your insurance doesn’t fully cover the services you received.
Your household income falls within the Federal Poverty Guidelines listed below
How to apply
- Download the Financial Assistance Program Application Here!
- Provide Proof of Income. This can include:
- Recent tax returns
- Pay stubs
- W2s
- Unemployment, Social Security, or pension income statements
- Submit Your Completed Form. We’ll review it and let you know within 15 business days whether you
qualify and what discount you may receive
Need help?
If you’re unsure whether you qualify or need help filling out the application, our billing team is here for you. We’re committed to supporting our community and helping patients focus on healing—not bills.
Call us at 206-838-7782 or email [email protected].
Household Size | Income Limit | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 person | Up to $62,600 | |||||||||||||||||
2 people | Up to $84,600 | |||||||||||||||||
3 people | Up to $106,600 | |||||||||||||||||
Add $2,000 for each additional person | ||||||||||||||||||
Puget Sound Surgery Center Billing
You may receive separate statements for your surgery from:
- Puget Sound Surgery Center
- Proliance Surgeons Inc.
- Puget Sound Orthopaedics
- Pacific Medical
- Anesthesiology
- Lab and/or pathology
