Bills and Billing Statements

As a Group Health member, you may receive bills for some of our medical and health care services, based on coverage, benefits, and cost shares outlined in your health plan's coverage agreement. In addition, if you have an individual or family plan (a plan that you obtain and pay for yourself, rather than a plan offered by an employer or group) you will receive a monthly dues (premium) bill.

The billing process varies depending on whether you received care at a Group Health Medical Centers facility or from one of our contract providers. This information will help you understand the billing process and statements and who to contact if you have questions.

Bills for Services at Group Health Facilities

Services provided by a Group Health care provider or at a Group Health facility (including Group Health pharmacies) are billed by our Patient Financial Services department. These bills are first submitted to your health coverage provider (your "health insurance company") or other payers of record for processing. If the service is covered by your plan, the bill will be paid by your coverage provider.

If it is determined that part or all of the service is not covered or that your plan requires that you pay for part or all of the service (commonly called your "patient responsibility" or your "cost shares"), you will be sent a bill. The most common forms of patient responsibility are copays, coinsurance, and deductibles. In addition, if you receive a noncovered service or your coverage has been terminated, you may also receive a bill.

For questions about these bills, contact Customer Service.

Billing for Services From Contracted Providers

When you receive health care services from a non-Group Health provider, that provider may send you a bill. In most cases, you will be billed only for charges that are your "patient responsibility." However, sometimes the provider may send you a full bill instead of forwarding it to Group Health first. If you receive such a bill, send a copy to:

Group Health Claims Administration
P.O. Box 34585
Seattle, WA 98124-1585

In Eastern Washington, blood drawn at a Group Health facility is routinely sent to Pathology Associates Medical Laboratory (PAML) for processing. X-rays taken at these clinics are also read by Inland Imaging. If there are any patient balances for either of these services, you will receive a bill directly from PAML or Inland Imaging.

For questions about bills from non-Group Health providers, contact the provider who sent you the bill. If the provider's office is unable to assist you, contact our Customer Service.