Systems Design Medical Billing
19265 Powder Hill Pl NE, Poulsbo, WA 98370
The statement you have received is for an ambulance transport provided to you or a family member by Northwest Ambulance. You may find the following information helpful.
If we do not have insurance information, a request was included with your statement.
If we have insurance information, the insurance company has been billed and the statement reflects any remaining balance that may be due.
If there is any other insurance that can be billed, please provide us with that information. Click the red button below to download the form. Please mail, fax or email a scanned copy of it to the billing service department. (See contact info at top of page)
A convenience fee will apply when making payments by credit card or eCheck. For credit cards, the fee is 2.95% of the invoice amount (Minimum Transaction Amount: $2.00). For eChecks, the fee is $3.00.
(NOTE: You will be asked for information appearing on your invoice/statement, so it should be readily available. Verify that Northwest Ambulance appears in the upper left corner of your invoice/statement.
- ONLINE: To make an online payment, click the Pay My Bill button.
(NOTE: You must have a valid email address to use the online option)
- PHONE: To make a credit or debit card payment over the phone, contact our Billing Services department at
- CHECK: Please mail checks or money orders to:
P.O. Box 3510
Silverdale, WA 98383
How to Contact Us
For more information or to make payment arrangements, please contact our billing department at the phone number, fax number or email address provided below:
1) Call our billing service department at (800) 238-9398. Please refer to the account number located on the top section of your statement.
2) Email a response to our request for insurance information form or any questions you may have to the following email address: firstname.lastname@example.org
3) Fax documents to the Northwest Ambulance billing service department:
Fax # 360-394-7094