Medical Billing

Follow the directions on the correspondence or contact Systems Design West at (800) 238-9398.

There are no out-of-pocket costs for District residents, property owners or business owners for our ground and marine services!

We credit your out of pocket expenses by the property taxes you pay as a business or homeowner or renter. There are a few times when you might receive correspondence from Systems Design West, our billing company in Silverdale, WA:

  1. An inquiry for insurance information.  Be sure to check the reason for the correspondence. In order to confirm your status you may be requested to sign a form allowing us to bill your insurance or verify your status as a resident.
  2. You did not give a local address when you were transported and the billing company thinks you are not a local resident.
  3. You have not responded to inquiries of the billing company.  In order to zero balance bill, we must confirm that you are a resident and that we have your current insurance information if you have any.
  4. If you still have questions, please call the billing company at the number listed on their correspondence. We’re glad to serve you.

If you received a bill from us because you are not a resident of the SJCPHD, we are glad to work with you to resolve your billing issues.

  1. We will work with you to get your bill covered by your insurance company.
  2. We have a charity care program available for those who are in financial difficulty.
  3. We’re a good neighbor and we’re islanders.  We understand and are on your side to help.
  4. If you still have questions, please call the billing company at the number listed on their correspondence. We’re glad to serve you.

Your Rights and Protections Against Surprise Medical Bills and Balance Billing in Washington State

Effective January 1, 2025

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. These costs are called cost-sharing. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network. “Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of- pocket limit. “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you take an ambulance ride, have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Insurers are required to tell you, via their websites or if you ask, which providers, hospitals, and facilities are in their networks. Hospitals, surgical facilities, providers, behavioral health emergency services providers and ground ambulance providers must tell you which provider networks they participate in on their website or if you ask

Emergency services

If you have an emergency medical condition, mental health or substance use disorder condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes ground or air ambulance rides, and care you receive in a hospital or in facilities that provide crisis services to people experiencing a mental health or substance use disorder emergency. You can’t be balance billed for these emergency services, including services you may get after you’re in a stable condition.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most these providers may bill you is your plan’s in- network cost-sharing amount.

You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

Health care providers, including hospitals, emergency behavioral health services providers, and ground or air ambulance providers, can never require you to give up your protections from balance billing.

If you have coverage through a self-funded group health plan, in some limited situations, a provider can ask you to consent to waive your balance billing protections, but you are never required to give your consent. Please contact your employer or health plan for more information.

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, anddeductibles that you would pay if the provider or facility was in-network). Your health plan will payout-of-network providers and facilities directly.
  • Your health plan generally must:
    • Cover emergency services without requiring you to get approval for services in advance (priorauthorization).
    • Cover emergency services by out-of-network providers.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in- network provider or facility and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit

If you believe you’ve been wrongly billed, you may file a complaint with the federal government at https://www.cms.gov/nosurprises/consumers or by calling 1-800-985-3059; and/or file a complaint with the Washington state Office of the Insurance Commissioner at their website or by calling 1-800-562- 6900.

Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.

Visit the Washington state Office of the Insurance Commissioner’s website for more information about your rights under Washington state law.

visit the washington state office of the insurance commissioner