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Know Whether We're Contracted and In-Network Before You Visit

This page describes our major insurance carriers. Please remember that your insurance is your tool for helping to make payments for medical services and is ultimately your responsibility. When you are seeing a new doctor, please always call the customer service phone number on the back of your insurance card or visit your insurance carrier's provider directory online to understand whether the doctor is in your network. Although we are contracted where described here, we are not necessarily in every network with that insurance carrier, so it's very important to check.

Premera, LifeWise, BlueCross BlueShield

Premera Blue Cross of Washington
We are contracted with Premera Blue Cross of Washington. We also take LifeWise, which is Premera's brand for individual insurance, typically high deductible plans. With Premera as our "home plan" here in Western Washington, we take all out-of-state Blue Cross and / or Blue Shield plans. For out-of-state BCBS plans, we send claims first to Premera for eligibility and pricing, and then Premera forwards those claims to the out-of-state home plans for payment (exceptions are BCBS Federal Employee Program and Regence BlueShield of Oregon, which are handled through Regence.)

We are in the following networks:

  • Global
  • Heritage & Heritage Plus 1
  • Heritage Prime
  • Heritage Signature
  • LifeWise Assurance Company
  • LifeWise Connect
  • LifeWise Health Plan of WA Preferred
  • Medicare Advantage

Premera PersonalCare Systems

Warning: We are >>NOT<< in any of the following Premera PersonalCare Partner Systems (Accountable Health Systems)

Please look at the upper-right area on the front of your Premera insurance card. If you see a heading that says, "PersonalCare Partner System," then look at the Accountable Health System mentioned immediately below. We are NOT a part of any of these AHS's.

  • EvergreenHealth Partners
  • MultiCare Connected Care
  • Northwest Physicians Network
  • The Everett Clinic Integrated Care Network
  • UW Medicine Accountable Care Network
  • Virginia Mason Medical Center

Premera may tell you that it is possible for you to go out-of-network with a referral, and that might be true, but these AHS's are really cracking down internally on referring outside when they have their own dermatologists in the network. Please don't try to use this insurance at our office! You will be held responsible for your bill if there are any problems with the claims. You would be better off just seeing a dermatologist in your network or continuing with us as a self-pay patient.

We are seeking to join EvergreenHealth Partners, but we do not yet have a timeframe.

View the Premera Provider Directory listings for: Susan H Kim MD , Campbell L Stewart MD , or Janie M Leonhardt MD .

Regence BlueShield, Federal Employee Program, Uniform Medical Plan, Healthcare Management Administrators, Asuris Northwest Health

Regence BlueShield (select counties of Washington)
We are contracted with Regence BlueShield. Regence manages the BlueCross BlueShield Federal Employee Program (FEP) for our state. Regence also manages the Uniform Medical Plan for State of Washington Employees. Patients from Eastern Washington who are insured with Asuris Northwest Health are also part of our Regence contract. Regence Group Administrators , Healthcare Management Administrators (HMA), and Bridgespan Health plans are also part of our Regence contract. We also take the Regence MedAdvantage Medicare Advantage Plan.

We are in the following networks:

  • Preferred
  • Uniform Medical Plan (for Uniform Medical Plan)

Warning: We are NOT in any of these narrow networks! Your insurance will not work at our office for the following networks:

  • Evergreen Partners-Virginia Mason
  • MultiCare
  • MultiCare Connected Care
  • Providence-Swedish Health
  • The Everett Clinic
  • UMP Plus - PSHVN (for Uniform Medical Plan)
  • UMP Plus - UW Medicine ACN (for Uniform Medical Plan)
  • UW Medicine

Patients are buying these narrow or limited network plans on the WA HealthPlanFinder web site and in many cases are totally unaware of what they are buying! And Regence does not send any remittance response when we send them a claim, so it may take months and months before we even realize you have seen us with insurance that won't pay anything at our office. Further, you will not get the benefit of the Regence negotiated rates for these claims; you will owe the entire charge balance.

View the Regence Provider Directory listing for: Lake Washington Dermatology .

Medicare Part B Insurance

Medicare Part B (Original Medicare)
We accept assignment from Medicare. Patients must have Medicare Part B for coverage of physician services. If Medicare Part B is your primary insurance, and you also have a Medicare Supplemental Plan as your secondary insurance, then we take all such plans. For our region, our Medicare Part B contractor is Noridian Healthcare Solultions, Jurisdiction F. We send claims to Noridian and your Medicare Supplemental Plan contacts Medicare on your behalf to set up automatic crossover of claims to the secondary plan. If you have only Medicare Part B, then you will be billed for remaining patient balances (a small annual deductible and 20% coinsurance). For certain services that may not be covered by Medicare, we are required to have you sign an ABN Waiver acknowledging that you have been informed of the possibility of non-coverage in order to legally bill you in the event that coverage for that service is denied.

Caution: We do NOT take Railroad Medicare , due to the small patient population, its separate credentialing process, and the fact that provider credentialing expires automatically if no patients are seen for 18 months .

View the M edicare Provider Directory listings for: Susan H Kim MD , Campbell L Stewart MD , or Janie M Leonhardt MD .

UnitedHealthcare, AARP, Tricare Insurance

We are contracted with UnitedHealthcare. UnitedHealthcare also owns the AARP brand of Medicare-related plans, including the AARP MedicareComplete Medicare Advantage Plans. While we do take these plans, please be sure to research whether your plan requires a referral from your primary care provider in order to see a dermatologist. We also take Tricare, and in our region, Tricare claims are handled by UHC Military West .

Caution: We do NOT take UnitedHealthcare Community Plan . This is a Medicaid-based plan. Even if UnitedHealthcare says we do, we don't.

View the UnitedHealthcare Provider Directory listings, then select the specific network on your insurance card to see if our providers participate . You cannot view a list of networks from a single provider profile page.

First Choice Health PPO Network

First Choice Health PPO Network
We are contracted with the First Choice Health PPO Network. A variety of employers in our area administer their own employee health insurance plans or have them managed by a third party administrator. If your insurance card has a First Choice logo on it, then you're covered!

View the First Choice Provider Directory listings. This directory does not allow linking to individual provider profile pages.

Aetna, Coventry, First Health Insurance

We are contracted with Aetna. Some other insurance carriers also use the Aetna PPO Network (we take cards with Aetna logo). We are also contracted with the Coventry and First Health PPO Networks. Coventry owns First Health, and Aetna has acquired Coventry, although Aetna and Coventry are still on separate contracts.

View the A etna Provider Directory listings for: Susan H Kim MD , Campbell L Stewart MD , or Janie M Leonhardt MD .

View the Coventry Provider Directory listings. This directory does not allow linking to individual provider profile pages.

Cigna Insurance

We are contracted with Cigna. Some other organizations such as Washington Teamsters Welfare Trust also have plans using the Cigna PPO Network. If your card has a Cigna logo, we take it! We are also part of the new Cigna LocalPlus network. Staff, here is a very useful online Quick Guide to Cigna ID Cards .

View the Cigna Provider Directory listings, then select the specific network on your insurance card to see if our providers participate . You cannot view a list of networks from a single provider profile page.

Kaiser Permanente of Washington (formerly Group Health)
Effective 5/1/2017, we are contracted with the Kaiser Permanente Commercial PPO Network. Please note your plan type on your insurance card. If you have an HMO or Medicare Advantage (which is HMO only) plan, please do *not* seek services at our practice. If you see us by mistake and without a prior authorization, we will never get paid. This is extremely disruptive to our practice. Please see one of the fine doctors within the HMO.

We are in-network for the following Kaiser Permanente plans:

  • Access PPO
  • Alliant Plus
  • Omni PPO
  • Options
  • Options PPO
  • Options Federal

We are *not* part of the HMO and do not take the following plans:

  • Alliance
  • Core (HMO)
  • Elect PPO
  • Medicare Advantage HMO

View the Kaiser Permanente Provider Directory listings.

MultiPlan PHCS PPO Network

We are contracted with the MultiPlan PPO Network. MultiPlan acquired PHCS (Private Healthcare Systems) in 2006, and PHCS is nowadays part of the MultiPlan networks. If your card has either of these logos, we take it!

View the MultiPlan Provider Directory listings.

Soundpath Health Insurance

Soundpath Health
Soundpath Health is an HMO Medicare Advantage Plan here in the state of Washington.

View the Soundpath Health Provider Directory listings. All of our providers have been contracted with Soundpath Health since December 2015.

We are *not* contracted with Humana
Humana is a national insurance carrier with a relatively small presence in Washington State. Unfortunately, we are not contracted with Humana. We have tried to join the Humana network, but they are currently not seeking to expand in our local marketplace. You may receive some out-of-network benefits from your Humana plan. For example, your claim might be allowed rather than denied, thus giving you the benefit of the discounted Humana rates, and your insurance might pay 50% of the allowed amounts for services. However, it is easier for us to say, "No, we are not contracted," to prevent cases of frustration where patients feel that they were confused or misled and then don't pay their bills.

Medicare Plans: Humana Medicare PFFS and Humana Medicare Supplement plans do not require contracts and these patients can see us with full benefits. Humana Medicare PPO patients will have their claims processed as out-of-network and typically will not be denied but will be processed according to the plan's out-of-network benefits. For example, a typical Humana Medicare PPO plan might have a $500 out-of-network deductible and then 40% patient coinsurance after the deductible is met. With this sort of plan you certainly can see us if you accept and acknowledge that you realize you are not receiving your full insurance benefits at our practice. However, please don't attempt to see our providers if you have a Humana Medicare HMO plan. We have never had a successful referral, and patients end up paying 100% of provider charges.

We do *not* take Washington Apple Health (Medicaid)
Unfortunately, we are not contracted with Washington Apple Health (Medicaid) or any plans based on Washington Apple Health, such as Molina Health and UHC CommunityPlan. If you have Washington Apple Health, please start with your primary care doctor to find a dermatology office where your medical services are covered.

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