Insurance and Billing Information

Does it sometimes feel like you need a degree in insurance to even understand your statement? Think of this as a crash course to help you understand how we bill for services and what questions to ask your insurance provider.

If you feel like the most complicated part of your health care is figuring out who is paying for what part, you are not alone. Fortunately, your WHA team includes financial coordinators. They can help you understand the potential WHA cost of your pregnancy, preventative care, test or procedure by giving you the information you need to follow up with your insurance company. Our billing specialists are also available by phone to answer any questions you have about your account or a statement you’ve received from WHA. We’re always here to help.

For our newly pregnant patients: Our financial coordinators will research your insurance benefits and prepare an estimate of your out-of-pocket expenses. They will share this with you around 12 weeks of pregnancy. In the meantime, here is a handy summary of billing and payments during pregnancy.

For pre-authorizations: We will contact your insurance company to obtain a pre-authorization if you are having a planned office or hospital surgery. Beyond this, it is important for you to know and understand your insurance contract and benefits. We are happy to explain general insurance terms and to help you know what questions to ask your insurance provider (including specific procedure codes, if you need them).

Refunds. We do everything we can to identify where you may have overpaid because of new insurance, a change of insurance or a difference in the amount your insurance company ended up paying for a particular service—and to refund that amount in reasonable time frame. If you believe you have made a payment in error or have any other issues or questions related to your payment history, please contact us.

COVID-19 testing. WHA offers COVID testing for our patients. We will bill insurance companies for this test. If you don’t have insurance, the cash price is $100.

Insurance Lingo

Co-pay

A co-pay is the flat fee determined by your insurance company that you pay each time you receive medical care, usually between $10 and $50. Although WHA is what’s called a “specialist” practice (as opposed to primary care), co-pays are determined by your insurance company and many insurance companies require only a primary care co-pay for certain types of visits, such as women’s wellness visits. If you pay a primary care co-pay in our office when your insurance company requires a specialist co-pay, we may bill you for the difference.