Billing

Understanding what you owe can be one of the most complicated and frustrating aspects of health care. At Seattle Roots Community Health, we want you to focus on your health care, not billing concerns. If you have insurance, many of your questions will need to go through them, but we can even help you know what to ask! If you don’t have insurance, we can help you discover your options.

Ways to pay your bill

Still have questions about billing?

Call us at (206) 299-1942!

Insurance and Billing

At Seattle Roots Community Health, we believe everyone deserves access to quality healthcare, regardless of their insurance status or ability to pay. We work with many insurance plans and help patients understand their coverage and healthcare options.

Insurance participation may vary by plan or service location. If you have a Preferred Provider Organization (PPO) plan or are unsure about your coverage, contact your insurance provider to confirm Seattle Roots Community Health is in your network.

Important Things to Know

  • Having insurance does not guarantee payment for services.
  • Patients are responsible for understanding their benefits, including co-pays, deductibles, coinsurance, and other out-of-pocket costs.
  • We verify insurance coverage as a courtesy. Your health plan may have specific requirements that affect coverage or payment.

For help understanding your coverage or benefits, call Insurance Support at 206-299-1942.

Understanding Your Insurance Benefits

Health insurance can be confusing. These common terms can help you understand what your plan may require.

Co-pay

A co-pay is a fixed amount you pay for a healthcare service, often at the time of your visit. Not all insurance plans require a co-pay.

Deductible

A deductible is the amount you must pay for covered healthcare services before your insurance begins paying its share. Deductible amounts vary by plan and are different from co-pays. Some services may be covered before you meet your deductible.

Coinsurance

Coinsurance is your share of healthcare costs after you meet your deductible. It is usually calculated as a percentage of the cost of a service. Not all plans include coinsurance.

Understanding Your Coverage

Primary Care Provider (PCP)

A Primary Care Provider (PCP) is the healthcare provider you select or are assigned through your insurance plan.

Some plans require you to designate a PCP and may limit coverage to services coordinated through that provider. If your plan requires a PCP assignment, make sure your PCP is assigned to Seattle Roots Community Health to receive the highest level of coverage available through your plan.

Medicaid / Apple Health

Medicaid, known as Apple Health in Washington State, provides healthcare coverage for eligible individuals and families. Some Medicaid plans require PCP assignment, referrals, or prior authorization for certain services.

Learn More About Apple Health

Medicare

Medicare is a federal health insurance program for adults age 65 and older and certain individuals with qualifying disabilities. Depending on your coverage, you may be responsible for deductibles, coinsurance, or other cost-sharing amounts.

Learn More About Medicare

Explanation of Benefits (EOB)

An Explanation of Benefits (EOB) is a statement your insurance company sends after services are provided. It shows what was billed, what your insurance paid, and any amount you may owe.

An EOB is not a bill, but you should review it for accuracy.

Need Help?

Our team is committed to making healthcare accessible and understandable. For questions about insurance, coverage options, or payment responsibilities, call 206-299-1942. We’re here to help you get the care you need.

Ways we can assist you

Understanding your bill

If you have questions about the bill from your insurance company, you can call us to talk you through it.

Insurance Eligibility Specialists

Seattle Roots Community Health employs full-time staff ready to help you find health insurance coverage for yourself or your family.

Self-pay quotes

If you are paying out of pocket, we can provide you with an advanced fee estimate. To qualify for our sliding scale, patients need to provide a verifiable proof of income.

Medicare and Medicaid (known as Apple Health in Washington) are welcome

If you lose your Medicaid or other insurance coverage, you can continue your same care at Seattle Roots Community Health (your fee will be adjusted according to our sliding scale).

You will never be denied care due to an inability to pay!

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” (GFE) explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Sliding fee discount

All uninsured patients – regardless of nationality or immigration status — are charged on a sliding fee scale according to income and family size. Click to view the sliding fee discount for Medical and Behavioral Health or for Dental services. 

Sliding Fee Discount Program Policy

Patients will never be denied services because of an inability to pay. Billing statements to patients will reflect this policy. In an effort to assist those unable to pay for medical care, Seattle Roots Community Health provides services based on a flat fee that is determined by Federal Poverty Guidelines, income, and family size.