Billing & Insurance

Newborns

In order for newborns to receive health insurance coverage for medical services, they need to be added to an insurance plan within the first 30 days of birth.  Please get in touch with your insurance provider for more details and assistance as soon as your child is born. If we can help you in any way, please contact us.

Good Faith Estimates

Patients who don’t have insurance or who are not using insurance have the right to receive a “Good Faith Estimate” of how much their medical care will cost.

Billing Policy

We encourage all families to become familiar with our financial policy, which is available in English and Spanish.

    • You have the right to receive a Good Faith Estimate for the total expected cost of your visit. This includes any known related costs, such as routine immunizations, screenings, and labs. Estimates do not include unknown or unexpected costs. Charges for unforeseen services, such as labs, tests, x-rays, or same-day procedures will be added to your final bill.

    • Healthcare providers are required to provide a Good Faith Estimate in writing at least one (1) business day before your scheduled appointment. You can also ask us or any healthcare provider for a Good Faith Estimate before you schedule an item or service.

    • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

    • Make sure to save a copy of your Good Faith Estimate.

    For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

FAQs

  • At Oregon Pediatrics, we understand how perplexing it can be to receive an unexpected medical bill. We're here to lend our support and guidance as you navigate through any billing concerns. Our billing team is always happy to answer questions you may have. You can give us a call at 503-427-2118.

    During a well visit, our main focus remains on your child's overall health and well-being. However, we recognize that health issues can surface at any time, prompting questions like, "Can you also take a look at...?" It's important to note that certain tests or procedures, while necessary for diagnosis or treatment, may not fall under the umbrella of preventive care according to insurance standards. This can sometimes lead to separate billing. These services could encompass discussions about new symptoms, unforeseen procedures, the management of existing conditions, or adjustments to medications like those for ADHD or asthma.

    We empathize with the complexities of healthcare billing, and our team is committed to providing you with clear information to assist you through this process. Your child's health and well-being remain our utmost priorities, and we're here to offer support every step of the way. Should you have any questions or concerns, please don't hesitate to reach out to us at 503-427-2118.

  • We follow the AAP’s Bright Futures recommendations for pediatric preventive care, which include:

    • Physical exam

    • Developmental screening

    • Hearing screen

    • Vision screen

    • Immunizations

    • Fluoride varnish

    • Lead level

    • Hemoglobin

    • Lipid panel screen

    • STD/HIV screen

    Some health plans do not cover screenings, even though they are the national standard of care. Call your insurance to check your benefits.

Insurance

Although we accept most major insurance plans, including the Oregon Health Plan, some limitations may be based on individual policies.  It is recommended that you reach out to your insurance plan to ensure we are in-network with your policy.  Should you need assistance or have any questions, feel free to reach out to our billing department at (503) 427-2118.

  • Aetna

    BlueCross BlueShield

    Cigna

    Coventry Health Care

    EBMS

    First Choice Health

    FirstHealth

    Health Net

    LifeWise

    Managed HealthCare Northwest

    Moda Health

    MultiPlan

    Oregon Health Plan (OHP)

    CareOregon

    Providence Health Assurance

    DMAP (Open Card)

    PacificSource

    Providence Health Plans

    Regence (except Regence OHSU network & Regence Beacon)

    TriCare

    TriWest

    UnitedHealthcare

    UMR