Financial Assistance & Arrangements

Washington Basic Health Plan
If you do not have medical coverage you may want to apply for the Washington Basic Health Plan. 
A representative from Choice Regional Health Network comes to Mason General Hospital every Tuesday. 
You can make an appointment by calling (360) 493-4550 or 1-800-981-2123.

Uncompensated Care
Mason General Hospital has a Charity Care/Uncompensated Care Policy.  This policy contains the guidelines for people to follow if they need any assistance with payment of their hospital bills.  This policy applies to those who who do not have insurance AND those who have insurance and is based on income levels.   Please ask at the Admitting area or the Business Office for a copy of the guidelines and application. Completed applications should be sent or delivered to the Business Office. 

Our Uncompensated Care Program is based on a sliding fee schedule extending up to 400% of the federal poverty level.  In order to qualify you need to do three things:

1. Apply at DSHS and be approved or denied medical coverage
2. Complete the Uncompensated Care application
3. Provide proof of income so that we can verify household income for the previous 12 month period

After all the criteria have been met, a determination will be made based on the income information.  You may qualify for a discount of up to 100% of your bill.

Credit Policy
Financial arrangements must be made prior to admission for any pre-scheduled services.  
A deposit will be requested for emergency services.
For those with insurance coverage, co-payments and deductibles are expected at the time of service. 
  
If payment arrangements are needed, they must be set up within 15 days from the date of service.  Payment arrangements are required whenever the bill cannot be paid in full at the time of the first billing statement.

The guarantor is responsible for making appropriate financial arrangements with the Business Office

If payment arrangements are needed, the payment schedule is as follows:
   Balance:                                                Months to Pay:
     Up to $74.99                                                       1                 
    $75.00 - $149.99                                                 2                    
    $150.00-299.99                                                   3
    $300.00 – 499.99                                                6
    $500.00-999.99                                                   9
    $1000.00-1499.99                                             18
    $1500.00-3999.99                                             24
    $4000.00 and up                                                36

Hospital Prompt Pay Discount
 A "prompt pay" discount will be granted for self-pay accounts where the Hospital is not required to bill any insurance.  The discount amount is 25% of the total balance due.  The account must be paid in full within 30 days from the date of the first bill in order to be eligible for this discount.  The request form for the discount is included with your initial bill that is sent to every self-pay patient (UB 92form).

Tax Adjustment
If you own a home in Mason County, you are eligible for a once-a-year tax adjustment with a yearly maximum of $250.00.  In order to qualify, you need to complete the Tax Adjustment Request Form and provide a copy of your Mason County Real Property Tax Statement.  Only one adjustment will be applied per year within 90 days from the date the service was billed, or 90 days from the date otherinsurance paid their full amount.  Past due accounts or accounts in collection are excluded.  Applications can be picked up at the Mason General Admitting Hospital desk or at the Patient Accounts Office.

Workman’s Compensation
For services that are the result of a work related injury the Business Office will need the following information:

• Employer name, address and phone number
• Date of Injury
• Claim number, if applicable
      

You must notify your employer of an on the job injury.  Your employer will need to submit additional information to the industrial carrier. Mason General Emergency Room Physicians can not help you with Re-opening a closed claim.  You will need to go to your primary care physician for this service.

Auto Insurance
For services related to a motor vehicle accident, the Business Office will submit a bill on your behalf once the following information is received:

• The name of the responsible party
• The name and phone number of the responsible party’s auto insurance carrier and Agent name.
• The guarantor’s auto insurance company name, phone number and Agent name
• Any claim numbers assigned to you for this particular accident    

Mason General Hospital will not wait for litigation with regard to an accident.  It will be your responsibility to pay the bill in a timely manner if insurance does not pay timely.

Contracted Payors
  Kitsap Physicians Insurance                             Molina Health Plan 
  Premera Blue Cross                                         Healthy Options and PEBB
  First Choice                                                     Community HealthPlan of Washington
  Regence, Blue Shield                                        Healthy Options
  Regence, Boeing                                              PEBB
  Aetna                                                              Medicare Advantage
  United Healthcare                                            Washington Medicaid
  Uniform Medical Plan                                        Noridian Medicare
  Pacificare HMO Secure Horizons                        Skokomish/Squaxin Indian Health                         
  Pacificare PPO  &  EPO                                      Champus (Tricare)
  Pacificare HMO Commercial
  Great West Healthcare
 

If you have questions relating to a provider’s preferred, participating, network or non-network status please refer those questions to your insurance company.  The patient is responsible for meeting the requirements of their insurance policy and all questions regarding insurance coverage or benefits must be directed to your insurance company.