Patient Financial Services

Billing & Financial Services Building
Patient Financial Services Building

590 Bogachiel Way
Forks, WA 98331

Mailing Address

530 Bogachiel Way
Forks, WA 98331

Hours

Monday – Friday
8:30 AM to 5:00 PM

Phone

(360) 374-4391

Toll Free

(866) 286-4955

Member of National Health Services Corps

Member of National Health Services CorpsClick to download PDF

Forks Community Hospital and Clinics are pleased to offer the following information to address your insurance & financial questions:

Paying Your Bill…

You may pay in person at the Patient Financial Services Building.

Meditech

Pay by Phone

360-915-5733

MyChart

Pay by Phone

360-374-4391

Payment Options

We offer the following payment options:

  • Prompt pay discount for uninsured
  • 1 year interest free payments (12 equal payments)
  • Pre-approved loan options with a low interest rate
  • Charity care assistance for qualifying patients

Financial Assistance

Plain Language Summary

Forks Community Hospital & Clinics are committed to serving all patients, including those who lack health insurance coverage and who cannot pay for all or part of the essential care they receive. We are committed to treating all patients with compassion. Forks Community Hospital & Clinics Financial Assistance Program provides financial assistance for qualifying patients who need help paying for emergency or medically necessary care they receive in Forks Community Hospital & Clinics. Patients must fill out an application to apply and must meet the eligibility requirements listed below to qualify.

Who is eligible for Financial Assistance and what are the requirements?

The program helps uninsured or underinsured patients who need help paying for all or part of their medical care. Patients are eligible for Financial Assistance when their Family Income is at or below 300% of the Federal Poverty Guidelines (FPG). Evaluation of other criteria may be required. Patients should consult with a Patient Financial Service Representative at (360) 374-4391 to determine eligibility and for assistance applying. Patients who have experienced a catastrophic event may be eligible under special circumstances, regardless of household income.

What does the program cover?

The Financial Assistance Program covers medically necessary care provided at Forks Community Hospital & Clinics.
Interpreters are available to you at no cost. The financial assistance application, policy, and this policy summary may be available in your language. For more information please call (360) 374-4391.

How do I apply?

  • Click the Charity Care Tab above
  • Visit the Patient Financial Services Department
  • Send a request by mail to: 530 Bogachiel Way, Forks, WA 98331
  • Call Patient Financial Services at 360-374-4391 or Toll Free at 866-286-4955

Please mail the completed applications, including all required documentation and information specified in the application instructions to:

Forks Community Hospital
C/O  Patient Financial Services
530 Bogachiel Way
Forks, WA  98331

We are able to process submitted applications only once they are complete, and will determine whether you are eligible according to the Forks Community Hospital Financial Assistance Policy.

We will not consider incomplete applications, but will notify applicants and provide an opportunity to send the missing documentation or information by the required deadline.

Charity Care

For more information about charity care, click here.

Financial Assistance Application

Charity Care ApplicationClick to download PDF

Payment Policy

Click to download PDF

Charity Care Policy

Click to download PDF

Charity Care Statement

Click to download PDF

 Asistencia Financiera

Financial Assistance Application-SpanishHaga Clic Aquí Para PDF

Asistencia Financiera para la Atención Médica

Haga Clic Aquí Para PDF

Política de Pago

Haga Clic Aquí Para PDF

Atención Benéfica

Haga Clic Aquí Para PDF

Strait-View Credit Union Application

Click for PDF

Contracted Payors

Clallam County Public Hospital District No. 1 will bill your insurance company if all needed information, and a copy of your insurance card, is presented at the time of registration.  You are expected to pay for charges that are not covered by insurance such as co-payment, coinsurance, non-covered and deductible amounts.  Questions regarding insurance coverage or benefits, must be directed to your insurance company.

Clallam County Public Hospital District No. 1 is currently fully contracted and in-network with the following payors/insurers:

  • Aetna
  • Amerigroup
  • Cigna
  • Community Health Plan of Washington (CHPW)
  • Coordinated Care
  • First Choice Health
  • Labor & Industries
  • Medicaid

  • Medicare
  • Molina Healthcare
  • Premera
  • Regence
  • Tricare
  • TriWest
  • United Healthcare

No Surprises Act

Good Faith Estimate Patient Rights Notice

Good Faith Estimate and Medical Care Cost

17031 - Office of the Insurance Commissioner - Your Rights and Protections Against Surprise Medical Bills and Balance Billing Notice_Page_2

Your Rights and Protections Against Surprise Medical Bills and Balance Billing

Costos Sin Sorpresas

Good Faith Estimate Patient Rights Notice

Estimación de Buena fe y Costo de Atención Médica

17089-Office of the Insurance Commissioner - Your Rights and Protections Against Surprise Medical Bills and Balance Billing Notice - Spanish_Page_1

Conozca sus derechos según la Ley de Protección de Facturación de Saldos

Need Insurance?

Click here for more information

Need Insurance?

The Affordable Care Act requires everyone to have health insurance. The goal is to make coverage more accessible and affordable for those who do not currently have health insurance or have limited coverage.

Washington State’s Health Benefit Exchange, called Washington Healthplanfinder, allows individuals and families who do not have employer-sponsored health insurance to enroll in a health plan and receive financial help. Health coverage offered through Washington Healthplanfinder includes Apple Health (Medicaid) and various qualified health insurance plans.

Enrollment for Qualified Health Plans through the insurance exchange closed March 31; however, enrollment into the Apple Health program is open throughout the year. If you have health coverage through Medicare, you don’t need to do anything.

How to Enroll:
  • Online: www.wahealthplanfinder.org
  • Call: 1-855-WAFINDER (1-855-923-4633) or TTY/TTD 1-855-627-9604
  • In person: In-person is available to help you enroll in coverage on the Health Benefit Exchange. More information can be found here.
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