Healthcare billing and payment can be complex and confusing. Below are some frequently asked questions to help you better prepare and understand how to pay for your healthcare.
Who do I contact to better understand my healthcare benefits?
Before scheduling your procedure or clinic visit, you should check with you health plan or employer to understand your coverage amount and benefits such as deductible, co-payment, or coinsurance amounts that you may owe after treatment.
What do I need to bring with me to each appointment?
Bring your complete health insurance information when you register including insurance cards and picture ID. You may be asked to sign forms such as release of information and financial consent. Provide updated information if you are a current patient and your personal or insurance information has changed since your last visit. The lack of current information can cause payment delays or denials that may ultimately leave you responsible for payment.
What are deductibles, co-payments, and co-insurance amounts?
A deductible is the initial amount that you must pay before your insurance plan begins to pay for your bills. Typically, a deductible is a fixed dollar amount.
A co-payment is a set amount paid for each visit to a provider. If you have a $50 hospital co-payment, you must pay $50 for each visit and your insurance company will pay for the remaining balance on all covered services. Co-payments may vary depending on the location such as hospital, clinic, and surgery center. Co-payment for providers, hospital, Ambulatory Surgery Center or other balances you may owe are due on the day you receive services. If you have any questions regarding your benefits, please call your insurance company.
Co-insurance is the percentage of the total cost of the health service that you must pay until you have reached your out-of-pocket maximum for a certain period of time. Co-insurance rates vary. After you meet your out-of-pocket maximum for that period of time, then most insurance plans will pay 100 percent of the allowed amount.
In some instances, you may be responsible for a co-payment, deductible, and co-insurance amount during the same visit. Please check with your health insurance plan if you have questions.
How do I know that the estimated amount from the billing department is the correct amount?
Most of the practices are providing you with an estimate of how much you will owe after insurance. Insurance reimbursement vary depending on allowed services, co-payment, deductibles, and co-insurance. Therefore, it is impossible for the billing department to know exactly how much your insurance company will pay or how much you will have to pay. The amount estimated is only the best guess of what you will owe after insurance payments. You will ultimately receive a bill that includes your actual charges, insurance payments, and what you actually owe.
What is in-network and out-of-network?
In-network pertains to treatment from doctors, clinics, health centers, hospitals, medical practices and other providers with whom your plan has an agreement to provide care for its members. Usually, you will pay less out of your own pocket when you receive treatments.
Out-of-network pertains to treatment from doctors, clinics, health centers, hospitals, medical practices, and other providers that do not have an agreement with your insurance to provide care to its members. You typically will pay more out of your own pocket when you receive treatment from out-of-network providers.
Most practices that continue treating out-of-network patients offer special payment plans.
What is my responsibility with requests from my insurance company?
After your visit, you must respond promptly to requests from your insurance company for additional information such as pre-existing conditions. These requests must be handled before payment can occur.
What if my condition is the result of an automobile accident?
If your account is a result of an automobile accident or other accident caused by another party, you can request itemized statements to be sent to any attorney involved. However, keep in mind that you will remain responsible for making payments on the account until the dispute is settled.
Still have questions?
If your question was not addressed here, please feel free to contact Oregon Billing and Collections at (503) 363-4355 (Monday – Thursday, 8:00am – 4:00pm; Friday, 8:00am – 3:00pm.)
For your convenience, we accept cash, check, and all major credit cards. Please tell us if you cannot pay your bill in full. Our Patient Financial Services will assist you and describe monthly payment plans.