Insurance Billing Policies

At Lavender Spectrum Health, we are committed to providing you with the best possible care and ensuring that our services align with the policies set by insurance companies. We bill insurance as a courtesy to you and in line with our values of being as accessible as possible to as many patients as we can. That being said, we need your assistance in understanding your insurance policy and benefits to reduce your risk of getting unexpected bills and creating financial hardship. 

We recommend contacting your insurance via phone or via web directory prior to your visit to ensure our providers are in network with your insurance.  We do not verify that our providers are in network with your specific plan and that is your responsibility.

It is also your responsibility to know what your financial responsibility is if any for your healthcare, including co-payment, co-insurance, and deductible. If you find out after a visit that you have not met your deductible and are billed for the cost of the visit, we are happy to help make a payment plan with you, but cannot waive the cost because you were not aware of your deductible. 

Co-pays are due at the time of your visit, and may be paid on the portal on the day of service. 

Late cancellation fees and no-show fees are due within 30 days of your visit, and if you do not pay these fees, you may be unable to schedule a follow up appointment until these fees are paid. Late cancellation fees and no show fees do not apply to patients who are insured by Medicare, WA Medicaid/ Apple Health, or OHP/ Care Oregon. 

If you do not pay your balance within 120 days of service, you may be discharged sent to collections. Please bring any billing errors to our attention as soon as possible and we will do our best to remedy them as quickly as possible. 

Many insurance companies will refuse to pay for specific blood tests or blood tests for a specific diagnosis. It is your responsibility to figure out your coverage for blood tests prior to having them drawn or you will be responsible for the costs. We are happy to provide you with a list of diagnoses and lab test codes for you to figure out what your insurance covers if you ask.

While we do our best to recommend specialists, imaging facilities, urgent care facilities, and laboratories who are in network with many insurance companies, we recommend you contact all outside providers and facilities before you go to ensure they are in-network with your insurance.  If your insurance is not in network with a facility we recommend, we may request your assistance in finding facilities that are in network with your insurance. 

We kindly ask that all patients decide no later than the beginning of their visit whether they are being seen for a wellness visit or a problem visit and communicate this with the provider. It is important for patients to understand the distinction between these types of visits, as it directly impacts the services provided and potential charges incurred. 

Lavender Spectrum Health

OFFICE POLICIES

Office Hours: 9 am to 6 pm Monday through Friday.  

Missed, Late Cancel or Late Appointments: We have reserved your scheduled appointment time for you and ask that if you need to cancel that you need to give us 24-hour advance notice. If you miss your appointment or cancel with less than 24-hour notice, you may be charged a missed appointment fee of $70. If you are more than 10 minutes late to your appointment, we may not be able to see you for the original allotted time, or we may need to reschedule your appointment and may charge you a fee of $70.  These fees may be waived for emergency situations and are not applicable to WA Medicaid/Apple Health patients or Medicare patients. If you have 3 late cancellations or no-shows you may be discharged as a patient from LSH.   

Telephone: We are more than happy to have a brief phone conversation to answer your questions. Please call or text our office at: (360) 727-1641.

Electronic Portal: The portal system is the preferred avenue for non-emergent and non-urgent correspondence, messaging, accessing the patient medical record, updating and filling out paperwork, and scheduling appointments. The portal and the electronic health record are both designed with security in mind. We advise you to understand, though, that no system is 100% secure.  It may take providers 72 hours to respond to a portal message.  

The following requests made over the portal require a follow up appointment: new medication/ medication changes, new referral, new diagnostic testing, new diagnosis, new laboratory testing, new paperwork (disability, FMLA, letter for surgery, etc) or modification to existing paperwork, discussing test results requiring follow up treatment or testing, any changes to your treatment plan requiring provider decision-making, or other healthcare decision-making as determined by your provider as needed to safely provide ongoing healthcare services for you.

Active/Inactive Patients: Patients are considered active if they have been seen within one calendar year. After that, their status becomes inactive. Inactive patients will have to re-register as new patients, as well as have a medical appointment, to regain “active” status. 

Emergency Care: We do not provide emergency medical care or after-hours care or treatment.  We are not on-call and are not accessible after business hours. If you are concerned that you may be experiencing a medical emergency, please call 911. If you are not experiencing a medical emergency, you may leave a voice message on our office phone or message us through our portal system, and we will strive to get back to you. 

Patient/Provider Relationship: LSH reserves the right to terminate the patient/provider relationship for reasons including, but not limited to patient noncompliance, frequently missed or cancelled appointments, behavioral issues including abusive or harassing behavior towards providers or staff, and/or non-payment of bills. LSH will use its best judgment in terminating a patient relationship and will communicate with the patient regarding the reasons for termination.   

Zero Tolerance Policy: LSH has a zero-tolerance policy for violence, threats, or any form of harassment.  

Social Media: Due to the importance of your confidentiality, privacy, and maintaining professional boundaries, LSH providers do not accept friend or contact requests from current or former clients on any social networking site (i.e. Facebook, Instagram, LinkedIn, etc.).  

Prescriptions: Typically, we require patients to have a follow-up office visit before we will refill prescription drugs and as directed by your provider.  Please provide us with 5 days’ notice prior to running out of your medication to refill your medication.  If you do not give us adequate notice, you may experience an interruption in your prescription.  

Diagnostic Laboratory Services Policy: Lab work that is billed to insurance carries no guarantee of coverage.

FINANCIAL POLICIES 

Payment Policies: Patients have 30 days to pay electronically on the portal or may provide payment over the phone. Balances greater than 30 days old may be sent to collections. Unpaid balances greater than 30 days old without a payment plan may result in the inability to schedule future appointments until payment and/or a payment plan are created.

If You Have Insurance:

As a courtesy, we submit claims on your behalf to your primary and secondary carriers. Co-payments, including co-insurance payments, and payment for services not covered by your insurance are due at the time of service. If you have questions or concerns about your coverage, please contact your insurance prior to services being rendered.  We do not have the resources to check your insurance coverage prior to your appointment.  

Medicare/Medicaid:

We will submit your claim directly to Medicare/Medicaid and will bill your secondary insurance after Medicare has paid their portion, if applicable. You are responsible for any amount that is not covered by Medicare and/or your secondary insurance. 

If You Do Not Have Insurance (Self-Pay):

Our primary care new patient visit cost is $200 and follow up visit cost is $150. Our mental health visit cost is $120 for a one hour session.

Acceptable Forms of Payment: We accept cards, cash & checks. If using:

• Cash – Please note for security purposes, we keep a limited amount of cash on hand and may not be able to make change. Please try to bring exact change or consider another form of payment. 

• Cards – LSH uses a highly secure credit card payment system. We accept all major credit cards.

• Checks – We accept checks that contain your full information, address, name, account number, routing number, etc. 

Past Due Accounts: Patients’ accounts that go unpaid for over 120 days or more may be submitted to a collection agency.  

Returned Checks: For returned checks, you will be charged a $100 returned check fee. 

I have read and understand these Office and Financial Policies and by signing below, I am agreeing to the Office and Financial Policies of LSH.

Signature of Patient/Responsible Party:

Existing patients may pay their bill via the patient portal below: