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:

• Online guest pay: www.ohsu.edu/guestpay
• Online patient portal: OHSU MyChart
• Phone: 503-494-8047 or 866-617-6855 (toll-free)
• Mail to: 

Mail your bill to OHSU Patient Billing Services 
P.O. Box 4674
Portland, OR  97208-4676

To pay your bill in person, visit OHSU Patient Billing Services
1400 S.W. Fifth Ave.
Suite 500
Portland, OR  97201

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.

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.

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 cost is to do one of the following:

• Contact your health plan and ask what your out-of-pocket costs will be for an upcoming stay.
• Access our online price estimate tool in MyChart, which can provide a clearer estimate and will be customized to your insurance coverage.
  • If you are a current OHSU patient with a MyChart account, you can log into MyChart and select the “Estimates” option.
  • If you are a prospective patient, please use our online price estimate tool in MyChart. You do not need a MyChart login to use it.
• Call OHSU’s Patient Estimate Team at 503-494-3508 to get an estimate for an upcoming procedure. 

Patients without insurance or who do not have enough insurance may qualify for discounts. 

If you need additional information, OHSU provides a list of our hospital charges below.

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 this file will contain our gross charges, self-pay rates, and negotiated rates per payor. We charge the same for all patients, but a patient’s responsibility may vary depending on rates negotiated with health plans and your individual coverage. If you are a potential patient please refer to our online price estimate tool in MyChart which can provide a clearer estimate and will be customized to your insurance coverage. Patients without insurance or do not have enough insurance may qualify for discounts.

OHSU

Download the comprehensive pricing transparency list

Download the professional charges list

Hillsboro Medical Center, formerly Tuality

Download the comprehensive pricing transparency list

OHSU works with the insurance plans and medical networks listed below, as well as many others. Please contact your insurer before visiting us to check whether:

• Your insurer covers our services.
• Your insurer considers OHSU and your provider to be in network or out of network:
  • In network means your insurer has contracts with OHSU and your provider, so your costs will be limited.
  • Out of network means your insurer does not have contracts with OHSU and/or your provider, so your visit will cost more.

• Aetna
  • Coventry
  • First Health
• CareOregon
• Cigna
• First Choice Health
• Health Net
• Health Net Federal Services, LCC –TriCare Program
• Humana
• Kaiser Permanente
• Moda (formerly ODS)
• MultiPlan
  • Beech Street
  • PHCS Network
  • PHCS Healthy Directions
• PacificSource
• Providence Health Plans
• Providence Exclusive Provider Organization (EPO)
• Regence BlueCross BlueShield of Oregon
• Samaritan Health Services
• Three Rivers Provider Network
• Tuality Health Alliance
• UnitedHealthcare

On April 1, 2023, the Oregon Health Authority began contacting Oregon Health Plan members to ask for their income information. This information will be reviewed to see who qualifies for Medicaid coverage. The Oregon Health Plan is Oregon’s Medicaid program.

This income review is called redetermination. It usually takes place every year. When the COVID-19 pandemic began, the federal government guaranteed Medicaid coverage and paused income reviews. That guarantee ended March 31, 2023. Oregon now has until June 2024 to review who qualifies for Medicaid.

If you are an Oregon Health Plan member:

• Make sure the state has your mailing address. To check or update your address, you can:
  • Go to one.oregon.gov and click on Manage Account.
  • Call the Oregon Health Authority’s Customer Service Center at 800-699-9075 weekdays between 7 a.m. and 6 p.m. Interpreters are available.  
  • If you are an OHSU patient: Call OHSU Health Services Customer Service at 844-827-6572 (for TTY users, 711) weekdays between 7:30 a.m. and 5:30 p.m.
• Watch your mail. All 1.4 million Oregon Health Plan members should get a review notice by January 2024.
• Follow steps in the notice within 90 days to keep Medicaid coverage. If you don’t respond within 90 days, you will have coverage for 60 more days.

Learn more:

• Change is coming to the Oregon Health Plan (video), Oregon Health Authority
• Habrá cambios en el Plan de Salud de Oregón (video) , Oregon Health Authority
• Redetermination FAQ, Health Share of Oregon

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 a.m. to 6 p.m.
• Friday: 8 a.m. to 5 p.m. 

Email
askus@ohsu.edu

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

OHSU Patient Billing Services Office
1400 S.W. Fifth Ave.
Suite 500
Portland, OR  97201