Pricing/Benefits

Dr. Shinsato is a preferred provider for Premera Blue Cross and Regence Blue Shield.  For any other insurance carriers, we are considered an out-of-network provider.  Our practitioners accept Personal Injury Protection (PIP) insurance which is used in the event of a motor vehicle accident/collision.  We understand that injuries are an inconvenience to your life and we work cooperatively with patients, their other providers, and their lawyers to provide effective, compassionate care so they may quickly return to work, recreational activities and their household duties.

We understand that navigating insurance benefits can be a confusing process.  We are happy to provide you with a helpful Insurance 101 (hyperlink this to the insurance 101 handout) handout that helps you learn more about your benefits.  Please take the time to review this document as there are definitions to common terms (copays, deductibles, co-insurance, etc.) and examples of how to understand what your insurance pays and what amount you may be responsible for.  If you have any questions, please send us an email or call us and we are happy to explain this to you more in detail.

To find out your benefits, please call our billing company, Puget Sound Medical Billing at 206-434-6317 and have your insurance card in hand.  You may leave a message with the following:

1. Your name, phone number, date of birth
2. The provider you wish to see
3. The insurance subscriber’s name
4. The insurance subscriber’s date of birth
5. The insurance company’s name (Premera, Regence, Aetna, First Choice, etc.)
6. The group number on your insurance card
7. The member number on your insurance card
8. The company that you or the subscriber has received their health insurance through

**You will receive a return phone call and a medical billing specialist will explain your insurance benefits available.

 We will determine your benefits and let you know prior to your appointment so you may have an idea of the estimated cost of your visit.

We require that payments be received in full at time of service with the exception of Personal Injury Cases (PIP; injuries as a result of a car accident), Labor and Industries (L&I; injuries sustained at work).  We accept cash, checks, major credit cards, health savings account cards, flexible spending benefit cards, and certain insurances (see above). At your request, Primavita will provide you an invoice (superbill) that you can submit to your insurance company or to your employer to take advantage of your flexible benefits plan.

Please call the number on the back of your insurance card to find out what you need to do to file an out-of-network claim. Reimbursement varies depending on your plan and your insurance carrier.  Please be sure to check with your carrier for out-of-network reimbursements.  I have provided a useful information sheet on what to ask when calling your health insurance company and my billing company will also determine what your benefits and coverage is for our services.

Cancellations If you make an appointment and do not cancel that appointment 24 hours in advance, you will be charged for that missed appointment.

Payment Methods Primavita Family Medicine accepts cash, personal checks, health savings account cards and major credit cards. If you have health insurance, please call our billing company, Alternative Medical Billing at 206-932-0870 so we can determine what benefits are available.

Our Convenient 50-50 Plan:

Did you know that 43% of employers in Washington do not offer health benefits (Seattle Times, April 2, 2009)? We believe in universal access to healthcare and back up our belief with the 50-50 Health Plan for patients without health insurance or on a high deductible plan. Why? Because eliminating the cause of a disease does not happen in a single visit and because prevention is a continuous effort.

Contact us for more information on the 50/50 plan, other cash payment options, and packages at 425-273-0741.