Insurance and Billing Information
Insurance Plans
We are contracted with the following companies, but not necessarily with all plans. You will need to double check with your insurance provider that we are in network for your specific plan. Sometimes databases are not up to date, and plans change, so feel free to contact us if you feel we should be in network but we're not found in their database. The following list is subject to change and not a guarantee that services will be covered. We will try to keep it as accurate and up to date as possible to be a useful preliminary tool to check if you're likely to be covered here.
List last updated: 2/16/2024
?Aetna* - https://www.aetna.com: *status currently in limbo; we have been unable to reach an agreement in our efforts to receive fair and reasonable reimbursement. We are hopeful that an agreement may still be reached, but if not we will need to terminate our participation. Please stay tuned.
Blue Cross Blue Shield/Regence - http://www.or.regence.com
Plans: Participating, Preferred, Value, Legacy
Cigna - http://www.cigna.com/consumer/index.html
Plans: Open Access Plus, Cigna PPO
First Choice Health - https://www.fchn.com
Plans: should have an Oregon state code.
Great West Care/One Health Plan - now part of Cigna
Health Net - http://www.healthnet.com
Plans: HMO, PPO, Triple Option
Health Share of Oregon/OHP: we are currently in the Legacy Health PacificSource network only - https://www.healthshareoregon.org/members/my-health-plan
Legacy Oregon Select Network (Regence) - http://www.or.regence.com/network/
Legacy Employee Health Plan - https://www.pacificsource.com/legacy/
MODA - http://www.modahealth.com
Plans: in network with Connexus and Synergy.
Re: OEBB and PEBB, Moda informed us that OEBB uses the Connexus network which we’re in, though you have the option of selecting a “PCP 360” provider for “enhanced benefits”. We are not currently a 360 provider but hope to be in the near future. PEBB on the other hand requires 360, so we won’t be compatible at all with that until we become a 360 provider. Stay tuned.
We are not in network with Beacon.
PacifiCare - www.pacificare.com
PacificSource - http://www.pacificsource.com
Plans: Many, including PSN, Pathfinder, Smart Health/Smart Choice, SmartAlliance, Legacy, Legacy Employee Health Plan, Legacy Health Share, Navigator, Voyager, BrightPath, see their provider directory for more details.
Private Health Care Systems (PHCS) - http://www.phcs.com
Providence Health Plans - http://www.providence.org/home/default.htm
Group Plans: the specific plans are unclear at this time as Providence is going through changes to their networks. Please confirm with them and/or with us about your specific plan.
Individual plans: not in network
Providence Health Share: not in network
Regence/BCBS Network - http://www.or.regence.com
Plans: Participating, Preferred, Value, Legacy
Tricare - http://www.tricare.mil
United Health Care - http://www.unitedhealthcare.com
Insurance Billing
We bill your insurance and collect copays at our office just like any standard medical facility. Your copay and coinsurance amounts are determined by your insurance plan, and will be the same here as at other medical facilities. For explanation of our other fees, please view this page.
Because we are a small clinic and do not have a huge team of people working for us, please help us keep the work of insurance billing to a minimum. If you receive a bill, please pay your bill promptly. The bills that we send you are a direct result of what your insurance company informs us that you owe. Therefore, most questions that come up regarding billing confusions are usually related to insurance and plan issues, so please contact them first if you need any clarification as to why you are being billed. Most unexpected charges are due to things like different deductibles for different types of visits, plan changes or deductibles resetting at the start of a new cycle, or certain procedures just not being covered. If after speaking with your insurance company it still doesn't make sense, then give us a call and we can try and help you sort it out.