Questions to ask your insurer

Is OHSU in network for my plan? Is my OHSU provider in network for my plan?

• In network: Your insurer has a contract with OHSU and/or your provider. Your costs will be limited.
• Out of network: Your insurer does not have a contract with OHSU and/or your provider. You will pay more.

What does my plan cover?

Your insurer will have the best information about what services, treatments, medications, medical equipment and fees it covers.

Do I need prior authorization?

Prior authorization is also called preauthorization or precertification. It means your insurer agrees before you receive care that it is medically necessary for you to have a service, treatment, medication or medical equipment.

Understanding your bill

Your bill may include charges for:

• Provider services
• Hospital services
• Facility fees

Provider services: These are charges from doctors and other health care professionals who took care of you.

Hospital services: These are charges for other parts of your care, including supplies and medications.

Facility fees: These are charges for some visits to OHSU clinics. We follow facility fee rules set by the federal Centers for Medicare & Medicaid Services. These fees are meant to cover the costs of running the clinic.

If you had anesthesia: You may get a separate bill for that service.

How to read your OHSU bill

No surprise billing

Federal law protects you from surprise billing:

• For emergency care from an out-of-network provider or facility.
• From out-of-network providers who provide these services at in-network facilities:
  • Anesthesia
  • Assistant surgeon
  • Emergency care
  • Hospitalist
  • Intensivist
  • Laboratory
  • Neonatology (newborn care)
  • Pathology
  • Radiology (imaging)

Learn more: What is a “surprise medical bill” and what should I know about the No Surprises Act?

OHSU price lists

We have the same pricing for all patients, but what you actually pay depends on your insurance plan. If you don’t have health insurance or don’t have enough insurance, you may qualify for discounts. Call 503-494-8505 to learn more.

• Download our pricing list

Get a cost estimate for your care

If you have health insurance:

• Contact your insurer and ask for an estimate.
• Call our Patient Estimate Team at 503-494-3508 to ask for an estimate.
• Use our online price estimate tool.

If you don’t have or are not using health insurance: You have a right to a written good-faith estimate at least one business day before care. If your bill is $400 or more above the  estimate, you can dispute your bill. The estimate will cover the total expected cost of nonemergency care. This includes:

• Medical tests
• Provider fees
• Medical equipment
• Hospital fees

Billing for MyChart messages

We may bill you or your insurance if you send us a medical message in MyChart that:

• Involves a medical decision.
• Takes your provider more than five minutes to answer.

As virtual care becomes common, we spend more time answering MyChart messages. Billing for in-depth answers lets your provider:

• Take the time to look at your medical history.
• Give you the best advice.

Please message your provider through MyChart only if you are willing to possibly be billed.

If you have Medicaid (Oregon Health Plan): MyChart messages are free.

If you have Medicare or other health insurance: We will charge a co-pay as if you had an in-person visit. If you don’t have a co-pay, the most you’ll pay is $77. Your deductible applies.

To see how much you’ll pay under your insurance plan:

• Go to our price estimate tool. Use CPT code 99423.
• OHSU patients:
  • Email estimates@ohsu.edu.
  • Call 503-494-3508.

If you don’t have insurance: The most you’ll pay is $77.

Pay your bill

By mail:
OHSU Patient Billing Services
P.O. Box 575
Portland, OR 97207-5975
(Please include payment coupon.)

In person:
Fifth Avenue Building
1400 S.W. Fifth Ave., Suite 500
Portland, OR 97201