Insurance, fees and Payment

Our staff is committed to helping you understand and fulfill your insurance requirements so that you can get the medical attention you need. We work with a number of health insurance plans, as well as Medicare. If you do not have health insurance, our staff will assist you in making arrangements based on your financial situation.

Office Visit CoInsurance
Payment is expected at the time of service. For your convenience we will calculate the estimated patient balance. Estimates will likely be lower than your actual responsibility if you are not a participant in a government sponsored program. The final amount due from you will be determined at the time your claim is paid by your insurance company.

Managed Care & Traditional Insurance
OHSU Medical Group will submit insurance claims for medical and surgical services. We do rely on you, the patient, for the most up to date information regarding your coverage so we can bill correctly. If your plan that requires authorization from your primary care physician, we require the referral or authorization number at the time of service in order to submit your insurance claim for payment. Without a referral or authorization form your primary care physician, your insurance benefits may be reduced or denied.

Plans with reduced benefits for OHSU.
Certain insurance plans allow patients to seek care outside the plan's preferred physician panel at a reduced benefit. For example the plan pays 80% for preferred physician services and 60% for all other physicians. Lifewise is one such plan in our area.

If you do not have insurance
Patients without medical insurance are requested to pay at the time of service. A 20% discount will be honored for all services that are paid in full at the time of service. If you cannot pay for medical services in full, you must consult with our financial counselor prior to your appointment.

Office Surgery procedures
The doctor may need to perform an in-office procedure while you are here for your appointment. This can include use of a scope to visualize your nasal passages or your throat. Insurance companies may consider these procedures "surgical". We do not have control over how these procedures are interpreted by insurance companies. We notify you of this issue in advance so you are not surprised when you receive an explanation of benefits from your insurance company that states a 'surgical service' was provided. Surgical services may be reimbursed at a different rate than an office visit.

Surgery
All of our physicians are surgeons. After seeing you the doctor may determine that you need surgery. We will partner with you to obtain approval from your insurance carrier for your surgery. We urge you to contact your insurance carrier to learn of your benefits as soon as possible. If you have a deductible that is not met or your insurance reimburses at a lower than average rate, we will ask for a partial payment on your surgery up front. In addition, if you are having a rhinoplasty or sinus surgery that we are billing to the insurance, we will ask for a $1000 or $500 deposit. If the total of your deposit and any insurance payments results in a credit balance, we will issue you a refund.

Flat Fee For Cosmetic Surgery
Our facial plastics doctors perform cosmetic surgery on a flat fee basis. A flat rate is an inclusive price for surgeon, hospital and anesthesia. Cosmetic procedures are not payable by insurance.

If you have any questions about our office policy, please contact our Financial Counselor at 503 418-5069