:::: PATIENT INFORMATION : PAYMENT INFORMATION :.

Payment Information

Pacific Breast Center is an approved provider for most major insurance carriers and health plans. We will submit your claim under the benefit coverage you specify, including workers compensation, auto insurance and/or personal injury.

We will need complete benefit information, including the name and address of your insurer, policy and group number, claim number, and the name of the policy holder or subscriber. For workers compensation, automobile accident, or personal injury cases, we require the name and address of your attorney and/or claims adjustor as well as your health insurance information. If required by your plan, please obtain a pre-authorization or referral prior to your appointment.

Financial Release Form (40 Kb)

You are ultimately responsible for the payment of your account. You will receive a monthly statement until the balance is paid. Please contact your insurer if no payment has been made within the first 30 days.

If you have been told that your insurance will not cover procedures done at the Pacific Breast Center, call us, we may be able to help.

If you have any questions or concerns about billing, please call (503) 619-1150.