Oregon
Medical Billing Services in Oregon
For Oregon practices: insurance billing at 4-8% of collections, credentialing, and no long-term contract. Oregon Health Plan, CCO, Medicare and commercial billing for Portland, Eugene, Salem and statewide.
Key takeaways
- 01The Oregon Health Plan requires claims within 365 days of the date of service, with a further 180 days to resolve a claim already submitted inside that window (OHA General Rules Provider Guide).
- 02Oregon delivers Medicaid through 16 regional Coordinated Care Organizations, each with its own rules; check each CCO's provider manual for its filing deadline.
- 03Oregon ranks condition and treatment pairs on a Prioritized List, and only services above the funding line receive Oregon Health Plan coverage.
- 04Oregon law (ORS 743B.287) bars out-of-network providers at in-network facilities from billing patients more than in-network cost-sharing.
Why Medical Groups in Oregon Rely on Medtransic
Oregon Payer Billing
We bill the Oregon Health Plan as well as the commercial insurers common in Oregon
Coders Matched to Your Specialty
Specialty-trained coders who know the payers and paperwork of your field
Dedicated Account Manager
One named person to call about your account, not a shared inbox
No Long-Term Contract
A fee of 4-8% of collections, and no long-term contract holding you in
What Physicians in Oregon Count On Us For
Oregon Health Plan Billing. Billing for Oregon Health Plan coordinated care organizations and fee-for-service OHP
HIPAA Compliant. A HIPAA compliant team, and a dedicated account manager who knows your practice
See How Much Revenue Your Oregon Practice Is Leaving on the Table
Get a free, no-obligation practice assessment. We'll analyze your claims, denials, and A/R to show you exactly where you're losing money.
Coverage Across Oregon, City to City
Portland Metro & Willamette Valley
Portland's healthcare market is anchored by OHSU (Oregon Health & Science University), Providence Health, Legacy Health and Kaiser Permanente Northwest. Oregon's Coordinated Care Organization model shapes Medicaid billing across the region, with an emphasis on value-based payment and care coordination.
Providence and Kaiser Permanente run large integrated systems, so independent practices compete with them for patients and payer contracts.
Primary care / psychiatry / oncology / dermatology / neurology
Southern & Central Oregon: Medford, Bend & Eugene
Southern and Central Oregon are served by Asante Health System in Medford, PeaceHealth in Eugene and St. Charles Health System in Bend. These communities include retirees, outdoor recreation workers and rural residents with limited access to care.
Rural CCOs can have different covered benefits, authorization requirements and quality metrics from urban ones.
Family medicine / orthopedics / urgent care / rural health / behavioral health
Eastern Oregon: Pendleton, La Grande & Burns
Eastern Oregon is sparsely populated, served by CHI St. Anthony Hospital in Pendleton, Grande Ronde Hospital in La Grande and Harney District Hospital in Burns. Long distances and farm and ranch economies make critical access hospital billing and telehealth important.
Eastern Oregon's CCOs include PacificSource Community Solutions and Eastern Oregon Coordinated Care Organization, each with its own covered services and billing requirements.
Family medicine / emergency medicine / rural health / general surgery / behavioral health
Answers on Billing Services in Oregon
Oregon delivers Medicaid through 16 regional Coordinated Care Organizations, such as CareOregon, AllCare, PacificSource and Trillium. Each CCO is a local managed care entity with its own covered services, authorization requirements and payment rules.
Oregon law (ORS 743B.287) bars out-of-network providers at in-network facilities from billing patients more than in-network cost-sharing. Payment disputes go through the federal No Surprises Act process, which Oregon's Division of Financial Regulation enforces.
Oregon ranks condition and treatment pairs on a Prioritized List, and only services above the funding line are covered by the Oregon Health Plan. Checking where a service falls on the list tells you whether a denial is worth appealing.
The Oregon Health Plan allows 365 days from the date of service, plus 180 days to resolve a claim already submitted inside that window. Medicare claims are due within one calendar year of the date of service (42 CFR 424.44). Each CCO and commercial plan sets its own limits, so check each CCO's provider manual rather than assuming one deadline.
PacificSource, Regence BlueCross BlueShield of Oregon and Moda Health are Oregon-based commercial carriers alongside the national insurers. PacificSource also runs Oregon Health Plan coverage in some regions, and each carrier has its own prior authorization rules and network structure.
Managed Billing for Oregon Practices, End to End
From eligibility checks to final payment, we handle your billing so you can focus on patients.
Claims Management. Claim submission and follow-up until each claim is paid or closed
Denial Management. Denied claims worked and appealed
Patient Billing. Clear patient statements and payment plans
Credentialing. Payer enrollment at $150 per application, per provider, usually 60 to 90 days with each payer, in our experience
Want a Second Look at Your Billing?
Get a free, no-obligation review of your practice's billing.
- Where claims are being denied, and why
- Which unpaid claims can still be recovered
- What billing would cost at 4-8% of collections
Specialties We Support Across Oregon
We are a specialist biller for mental health, behavioral health and therapy, and other specialties are welcome.
- Occupational Therapy
- Behavioral Health
- Mental Health
- Speech Therapy
- Psychology
- Psychiatry
- Substance Use Treatment
- Physical Therapy
- ABA Therapy
- Primary Care
- Dental
Put Medtransic to Work in Oregon and Stop Chasing Claims
Let us handle your medical billing so you can focus on patient care