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Financial Information

At Astria Health, it is our mission to deliver America's best local healthcare. Consistent with fulfilling that mission, we take a positive and proactive approach to patient billing and collections. Our goal is to coordinate payment for services in the most efficient, timely and customer-oriented manner possible. We understand that the billing and collection process can be confusing. In order to assist you in understanding these services and to answer any questions you might have, please review the following.

Financial Information

Frequently Asked Questions

How can I help reduce the wait time at the hospital?

If your physician's office scheduled your service at our hospital in advance, we will make every effort to ensure that you are preregistered prior to your arrival. If your physician's office was unable to schedule your service in advance, you can preregister by contacting the registration department prior to your service. If you preregister, your wait time may be reduced by 10 minutes or more. When you come to the hospital on the day of your service, please bring your insurance card, photo ID and the order from your physician. If at any point in our registration process you have not experienced our commitment to excellence, please ask to speak with a member of management.

Why do I have to show my ID each time I visit the hospital?

Our primary concern is for your health and safety. We request your identification to ensure that we access and update the correct medical record. It's also to protect you from fraud. Statistics released by the Federal Trade Commission indicate that more than 3.25 million Americans have had their personal information used by someone else for illegal activities. By requesting proof of identity, we are able to safeguard your personal medical and financial information.

What insurance plans are accepted?

Astria Health accepts the following insurance plans:

Premera Blue Cross

  • Global
  • Heritage
  • Heritage and Dental Choice
  • Heritage Prime
  • Heritage Signature
  • Heritage Signature and Dental Choice
  • Individual Signature
  • LifeWise Assurance Co.
  • LifeWise Health Plan of Washington Preferred
  • LifeWise Primary

Regence Blue Shield

  • Participating
  • Preferred
  • Individual and Family Network
  • RealValue
  • Option
  • Regence MedAdvantage PPO 

Aetna

  • Open Choice Network
  • Managed Choice Network
  • Elect Choice Network
  • Open Choice Network with Aetna Managed Pharmacy Network
  • Managed Choice Network with Aetna Managed Pharmacy Network
  • Elect Choice Network with Aetna Managed Pharmacy Network
  • Medicare Advantage

 United Healthcare

  • Charter
  • Choice
  • Core
  • Navigate
  • Options
  • SignatureValue
  • Select
  • Medicare Advantage

 First Choice

  • First Choice PPO Network

Kaiser Permanente

  • Core
  • Boeing HMO
  • SoundChoice
  • CoreSelect
  • Medicare Advantage
  • Medicaid

Coordinated Care:

  • Medicaid
  • Commercial Exchange

WellCare

  • Medicare

Molina

  • Medicare
  • Medicaid
  • Commercial Exchange

CHPW

  • Medicare Advantage
  • Medicaid 

Cigna

  • Cigna PPO

Humana

  • ChoiceCare Network PPO
  • ChoicePOS
  • Humana/ChoiceCare Network PPO
  • Humana/ChoiceCare+ Network PPO
  • National POS - OpenAccess
  • National POS - OpenAccess Plus
  • Oscar+Humana National Network

TRICARE

Amerigroup

Medicare

Medicaid

Why do I need to bring my insurance card to each visit?

In order to file an insurance claim on your behalf, it is necessary to make certain that we have the most current and accurate information about your insurance coverage and specific plan benefits. That is why it is our policy to verify your insurance information during each visit.

Why do I have to answer the same questions each time I am registered?

Many of the questions we ask are either required by your insurance company or requested to ensure that we have the most accurate information on file. This information allows us to satisfy the requirements of your insurance company and to file your claim with little or no involvement on your behalf. Certain questions are mandated by the federal agency of CMS (Centers for Medicare and Medicaid Services).

Why am I asked to pay my co-payment and deductible on the day of service?

It is our goal to provide you with a comprehensive overview of your insurance benefits prior to receiving hospital services. Our process allows you the opportunity to understand how your health insurance benefits will be applied to the service and the opportunity to ask specific questions about your insurance benefits. We will also take this opportunity to discuss the financial options available for any amount not covered by your insurance. In keeping with the terms of your agreement with your insurance company, as well as the agreement between the insurance company and the hospital, it is our practice to request that co-payments and deductibles be paid prior to or on the day of service.

How may I pay?

We accept payment by cash, check, or Visa, Mastercard, American Express and Discover cards.

What does "Provider-Based" designation mean?

This is a Medicare status for hospitals and clinics that comply with specific Medicare regulations. Medicare has determined that this hospital has met these regulations and has been designated as such. This status requires that the hospital send two separate bills to Medicare, one for the facility and one for the physician. This means you may receive two billing statements and two separate Explanation of Benefits statements from your insurance company for one date of service.

Helpful Definitions

  • Beneficiary: A person who receives benefits of any insurance plan or policy
  • Claim: A request for payment for services submitted by the provider
  • Co-insurance: A specified percentage of covered expenses that the insurance carrier requires the beneficiary to pay toward eligible medical bills
  • Co-pay or Co-payment: A specific set dollar amount contracted between the insurance company and the beneficiary to be paid prior to any services rendered
  • Covered Services: Services for which an insurance policy will pay
  • Deductible: A specified dollar amount of medical expenses that the beneficiary must pay before an insurance policy will pay
  • Explanation of Benefits (EOB): A statement from an insurance company showing the processing of a claim
  • Medically Necessary: Treatments or services that insurance policies will pay for as defined in the contract
  • Non-Covered Services: Services for which an insurance policy will not provide payment. These services are to be paid by the patient at the time of service
  • Precertification/Authorization: A service-specific requirement that your insurance company's approval be obtained before a medical service is provided
  • Provider: A person or organization that provides medical services
What are my rights under the 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 at www.insurance.wa.gov or call 1-800-562-6900 

Charity Care Policy

ASTRIA SUNNYSIDE HOSPITAL

ASTRIA TOPPENISH HOSPITAL

Standard Charges

Astria Health Hospitals' standard charges and chargemasters can be found on the hospitals' individual location pages

The estimates we provide are for care without complications. Actual charges may be different for specific patients due to medical condition, length of time spent in surgery or recovery, necessary specific equipment, supplies or medication, complications requiring unanticipated procedures or other treatment ordered by the physician. When comparing charges with other hospitals or provider practices, it is important to understand that their charges may or may not include both the hospital charges and the charges for services provided by doctors or other providers. This information is not a quote or a guarantee of what the charges will be for a specific patient’s care. This charge information does not include the professional services provided by a physician, surgeon, radiologist, anesthesiologist, pathologist, advanced practice nurse or other independent practitioners.

Patient & Visitor Information

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