Billing and Insurance

Confused about the health care billing process?

We are here to walk you through it. The first thing to figure out is if you have health insurance. Your bill will depend on whether you have insurance and what type of coverage you have.

Our customer service department can help you with:

  • Understanding your bills
  • Reviewing how the billing and collection process works
  • Exploring payment plan options to resolve your account
  • Apply for financial assistance, if needed

Our billing process

Step 1

We submit a claim to your insurance company based on the information provided when you register at OHSU.  Co-payments are expected at the time of your visit.

What you can do to help

  • Provide your complete personal health insurance information when you register.
  • Inform us if your personal or insurance information has changed since your last visit.
  • Know your insurance coverage and benefits. Contact your insurance company before your visit to OHSU to verify your benefits and coverage requirements.

Step 2

We wait for payment from your insurance company. If payment is not received in a reasonable amount of time (30 days), we may ask for your help.

What you can do to help

  • If you do not receive an explanation of benefits from your insurance company within 30 days, please contact them to find out the status of your claim.
  • Your insurance company may ask you to provide more information. If so, please respond quickly, and let us know the information you’ve provided to the insurance company so we can update our records.

Step 3

After your insurance company has made payment, you will be expected to pay the amount due. If your account becomes past due, you may receive up to three balance due notices and three phone calls.

What you can do to help

  • When you receive a balance due notice, please pay your bill promptly.
  • If you have questions about these billing statements, please call Customer Service; toll free at 866-617-6855.
  • Keep your billing statements for your records. The billing statements may be helpful when reviewing the explanation of benefits you receive from your insurance company.
  • If you are unable to pay the balance, please contact us. We can discuss options for payment plans or financial assistance, depending on your circumstances. Information and guidelines for financial assistance are also available online.

If you do not have insurance, we will send you a bill for any amount that you did not pay when you received services at OHSU.

Financial assistance

  • To see if you qualify for state or federal medical assistance, please contact OHSU Financial and Medicaid Services at 503-494-1671.
  • If you are unable to pay your bill in full, please call us at 503-494-8047 or 866-617-6855 (toll free). We have payment plans and financial assistance programs that you may qualify for.

How to read and pay your OHSU bill

In this guide, we use a sample OHSU bill to show you what each part means and how to understand it.  

We have many ways to pay your OHSU bill:

Patient Billing Services
P.O. Box 4674
Portland, OR 97208-4676.

Please include your payment coupon with your payment.

We accept Visa, MasterCard, American Express and Discover Card. You can also pay by check. 

If you are unable to pay your bill in full, please call us at 503-494-8047 or 1-866-617-6855 (toll free). We have payment plans and financial assistance programs that you may qualify for.

Please note: Online payments cannot be used to pay your OHSU dental bill, your OHSU student health bill, or your bill from Richmond or Scappoose Clinics. Please refer to the billing statement for information on how to pay these types of bills.

You will receive one bill for both hospital and doctor services.

  • Your OHSU Hospital and Clinic charges are for your hospital stay or clinic visit.
  • Your doctor's fees include the costs of medical or surgical care. It also includes costs for any doctors who helped review test results.
  • You may also receive a separate bill from OHSU Anesthesia.

Hospital price list

Your hospital bill should never be a surprise, but it can be hard to predict what is needed to treat an illness or restore a person's health. The price you pay is based largely on your insurance coverage. The best way to plan ahead for any costs is to:

  • Contact your health plan and ask what your out-of-pocket costs will be for an upcoming stay, or
  • Call OHSU's estimate team at 503-494-3508 to get an estimate for an upcoming procedure.

OHSU provides a list of our hospital charges below. Please note that these amounts are gross charges and not necessarily what we receive from health plans or patients. We charge the same for all patients, but a patient's responsibility may vary depending on rates negotiated with health plans and your individual benefit coverage. Patients without insurance or do not have enough insurance may qualify for discounts.

Insurance

Frequently asked billing and insurance questions

You will receive only one statement for both hospital and provider services. If you have received any anesthesia services, you may get a separate statement for these services.

How to read your OHSU bill

For example, if you have outpatient surgery, you will receive one bill from OHSU for hospital and provider charges and a separate bill from the anesthesiologist.

OHSU follows national guidelines and billing standards mandated by the Center for Medicare & Medicaid Services (CMS) for all patients and all visits – in the hospital setting and in outpatient settings. CMS has defined facility fee insurance billing codes for outpatient "clinic visits" to reimburse hospitals for the level/intensity of the nursing services and hospital resources used in an outpatient clinic setting. The fees take into account the operating and overhead costs related to the building, service provided by our clinical and support staff, supplies and equipment, as well as administrative costs. 

Physicians who treat patients at hospital-owned facilities typically are not owners or employed by those facilities. When billing insurance companies, the physicians accept lower fees/insurance reimbursement than physicians who use their own equipment, supplies, staff and facilities

Physicians who own their own facility and resources use insurance billing codes that include their facility/overhead costs into a single patient bill for an office visit and are reimbursed at a higher rate by insurance providers.

No, OHSU charges a facility fee only when the service provided meets the definition and criteria established by CMS for a "clinic visit." There are some outpatient services, such as lab, radiology and rehabilitation therapy, that have different codes established by CMS. In those situations, the facility costs are already built in to the reimbursement rate, so patients are not charged a separate fee.

Your insurance provider will send you an Explanation of Benefits (EOB) notice that details the amount it has paid, any non-covered or denied amounts and the remaining balance that you are responsible for paying to OHSU. Review your EOB carefully, compare it to your OHSU billing statement and call your insurance provider or an OHSU Customer Service Representative right away if you have questions or concerns.

As a courtesy, we bill both your primary and secondary health insurance carriers. To insure proper and prompt processing of your claim, please be sure to verify the insurance information we have at the time of registration.

If you do not have health insurance, Medicare or Medicaid, we will send you a bill for any balance not paid at the time services are received.  Please pay the bill, or call us to make payment arrangements, as soon as you receive it. You may make your payments by check, Visa, MasterCard, American Express or Discover Card.

Statements are issued monthly after we receive payment from your insurance company. 

We ask that payments be made at the time of your visit so you won’t be inconvenienced with a statement sent to your home after your visit. It also helps us reduce costs and saves you the trouble of mailing a payment back to OHSU.

Insurance companies should notify you directly when a claim is denied. If you have not received an Explanation of Benefits, you should contact your insurance carrier directly. 

Please pay the balance due using one of the various payment options.

We know that sometimes it is hard to pay your bill, even if you have insurance. If you are still having trouble paying after your insurance has been applied to your bill, please call us at 503-494-8047 or 1-866-617-6855 (toll free). We have payment plans and financial assistance programs that you may qualify for.

If you still cannot pay your bill after all other attempts have been made, we will work with our collection agencies, including the Oregon Department of Revenue, to recover payment with no interest charged. We care deeply about our patients and will never suspend your license, report you to credit bureaus, place liens on your property, charge late fees or file judgments/suits in an attempt to collect a debt. 

As a patient, you should know and understand your insurance plan benefits and your responsibility for any deductibles co-insurance or co-payment amounts prior to any visit.  Not all services are covered in all insurance contracts. If your insurance plan does not cover a service or procedure, you may be billed for full payment of the bill. 

To find out what your insurance plan covers and what your financial obligation may be, call the Customer Services or Member Services Department of your insurance company (the phone numbers are on your insurance card).  

Make sure that your insurance company lists both your doctor and hospital as a participating provider.  If you go to an out-of-network provider, you may have a greater financial responsibility for services provided that is not under contract with your health care plan. Your insurance company can assist you in finding an in-network provider to limit the amount of money you will have to pay for care.

There are several ways to contact the OHSU billing office:

Phone
866-617-6855

Hours
Monday-Thursday 
8-6 p.m.
Friday 
8-5 p.m. 

Email
askus@ohsu.edu

Mail
P.O. Box 575
Portland, Oregon 97207-0575