We know the cost of medical care and the issues surrounding billing can be very confusing. You have the right to know what to expect when using our facilities.

Here we will answer the most frequently asked questions about handling the billing for your health care.

If you do not get all the answers you need here, our staff will be more than happy to assist you.

Cost of Health Care

Patients frequently ask, "What will this visit cost me?" In many instances, it is hard to pinpoint the exact cost up front as the care provided dictates the cost. However, the following can give you an idea of what your bill may be.

• Clinic visits - clinic visits can be as low as $50 if you are a return patient and have a simple medical problem. As the problems become more complex and involve more parts of your body, the charge will go up. Our average clinic visit charge is $75. If you have a procedure done at the visit, it can increase your bill.

 
• Emergency room - The emergency room is a very expensive place to get medical care. It is staffed with people trained in emergency care and equipped with specialized equipment to handle life-threatening events. Our emergency visit bills include both the hospital fee and the emergency physician's fee, so you will not get separate bills for your emergency visit. The minimum average bill for an emergency visit at our facility is $350.00. If your condition is such that the physician orders lab and x-ray services, the bill will be much higher. If the physician performs a procedure (e.g., sutures), this adds to the bill.

 
• Outpatient services – Services provided in the outpatient setting, like x-ray and physical therapy, usually have set fees for the kind of service provided. Again, our bills include the hospital fee and the physician fee so you will get one bill from us. The department can give a quote as to the amount of the test or service provided. You can also request a quote from the business office on the specific test or service you are having done. This quote will tell you how much the basic test costs. If the physician asks for further studies, the amount of the bill will be higher.

 
• Outpatient surgeries - Our outpatient surgery charges vary depending on type of surgery done and complexity of surgery. You can call the business office for a basic quote, but the actual bill will depend on such factors as time spent in the hospital, medications used, special supplies used, etc.

 
• Inpatient services - Medical inpatient services average $5,500 per visit. If the patient is in intensive care, the bill will average $7,000. Surgical inpatient services will average $7,500 and can go as high as $10,000. Again, if the patient is in intensive care, the cost of the services will be higher. The billing office can give an estimate of average cost for a particular inpatient stay, but the actual cost will vary due to patient condition and healing time.

Billing Issues

We know health care expense is of concern to you even if you have insurance, and we want to help. The business office will assist you with billing issues to facilitate prompt payment on your account. Many insurance companies require prior authorization for treatment. The accurate information given to us at registration allows for verification of coverage and authorizations, referral to other health care providers, as well as rapid billing of the account to the appropriate payer.

• Billing cycle: Our statements reflect the status of your account. The initial statement refers to the service provided. Subsequent statements will just show the balance forward. If you can not remember what the balance forward refers to, you can call our office and we will give you the exact dates of service indicated in the balance forward. Payment is due upon receipt of the statement unless other payment arrangements have been made.

 
• Payment arrangements: We want to help you resolve medical billing issues. It is important that you let us know if you need help so we can direct you to the best plan. We have several plans for helping you with the payment of bills.

If the balance is large, we can set up a pre-approved payment plan through a local bank that will allow you to make payments over an extended period of time. Payments can be as low as $15 per month.

If you can resolve the balance in less than a year, we can set up payments directly to the facility on a monthly basis.

Sometimes medical bills can be overwhelming. We work with Consumer Credit Counseling and accept payments they set up for you. Consumer Credit Counseling is an organization that works with people who find themselves deep in debt and need help to resolve the credit issues. We encourage you to contact them for an appointment. Their number is (541) 997-8990.

Our mission is to provide care regardless of ability to pay. If other options don't help you, we may ask that you provide financial information to us so we can explore ways to help you with any medical bills.

• Medicare patients: We accept assignment on Medicare. Accepting Medicare assignment does not mean we accept what Medicare pays as payment in full. What it means is that we agree to the price set by Medicare and will charge you no more than the co-pays or deductibles outlined by Medicare on the explanation of benefits. We ask that you not pay until you receive a statement from us showing a patient balance due. Medicare will determine the allowable amount, what they will pay, and what is your responsibility. If you have secondary insurance, we will bill them for you.

Since the arrangement with secondary insurance is between you and your insurance company, we seek your assistance in any follow-up on the claim or lack of payment in those instances where you disagree with the insurance coverage of co-pays and deductibles from Medicare.

• OMAP/Oregon Health Plan patients: Always bring your valid Oregon Medical card with you to each appointment. If you do not have a card, please get a temporary card from your case worker before coming to your appointment. Services provided without the card or services not covered by the card will be billed to you. If you do not have a card, you will be asked to sign a waiver indicating you realize you will be financially responsible for the service provided.

 
• Private Insurance patients: Please provide us with a copy of your insurance card. We will be happy to bill your insurance for you. We participate with many insurance companies and will honor the payment rates of those we participate with. Please understand that your insurance policy is a contract between you and your insurance company. Our submitting the claim for you does not take away your responsibility for payment on the claim. We will assist in claim follow-up but may need your help in resolving payment issues.

 
• Co-pays and Deductibles: Many managed care programs have a fixed co-pay or deductible for each visit. You will be expected to make this co-pay or deductible payment at the time of service.

 
• Refunds: Refunds for overpayment on claims will be processed daily and issued as soon as possible. If you have an open account, your payment may be moved to cover the balance on the open account before refunds are made.

 
• There will be a $15 service fee on all returned checks (NSF, account closed, etc.)

Working With Your Insurance

If you need to contact your insurance about an unpaid bill, or if you have a dispute about the amount that has been paid, the following hints may help you get the information you need.

• Before you call: You will need to have the following information available.

Your insurance card, or your policy number and identification number.

The date of service for the bill you are asking about

The name of the facility or doctor you saw.

• When you call:

Write down the name of the person you are talking to.

After you give the person the policy information and date of service, explain your problem. Avoid a "he said - she said" situation. Just state plainly the issue. Example: "Why has this not been paid?" or "I received an explanation of benefits and this was denied. Can you tell me why?"

If the insurance person says they need more information, ask them to tell you specifically what information they need. This will help you determine where to go to get the information needed.

If the insurance person says "we don't have that claim," ask "How long does it take from the time a claim reaches your business for it to get in your system so you can see it?" Some insurance companies take up to 30 days from the time the bill is received in the mail until it gets entered into their system. Rebilling just triggers an explanation of benefits that says it is a duplicate claim.

If the insurance company does not have the claim, ask if they have a fax number so you can fax the claim to them. Ask the person you are talking to if you can fax it to their attention.

When you get the information you need, the fax number and who to send the claim to, you can call your health care provider's billing office and we will get copies of the needed report, re-bill the insurance, or fax reports or bills to the proper person, or send information to help resolve the billing problems. Our phone number is (541) 997-9672. Our customer service hours are from 10 a.m. to 3 p.m., Monday through Friday.