Frequently asked billing questions.
What are deductible, co-payment, 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 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-payment may vary depending on the location such as hospital, clinic, and surgery center.
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 the role of Oregon Billing and Collections?
Oregon Billing and Collections is a billing company that works on behalf of clinics, surgery centers and providers. We are committed to providing care to all patients with a high level of respect and skill. We will submit claims to your insurance company and if applicable, to your secondary insurance company as a courtesy. If there is a patient responsibility, we will send you a statement to notify you of any remaining balance.
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.
We hope the information in this brochure helps you understand what we can do to assist you, your insurance plan, and how we can help if you have difficulty paying your bills.