Medical Billing Services in Oregon
As a remote-first medical billing company serving Oregon practices statewide, MedPrecision pairs OR-specific payer expertise with AAPC-certified billing experts. Oregon's Medicaid program runs through Coordinated Care Organizations rather than a single state plan, and the Oregon Health Authority's General Rules Provider Guide sets a 365-day filing window from the date of service for Medicaid claims, with a further 180 days to resolve a claim submitted inside that year. The prompt-pay rule is ORS 743B.450: an insurer pays a clean claim or denies it within 30 days of receipt, and where it needs more information it must ask in writing within those 30 days and then pay or deny within 30 days of receiving the answer. ORS 743B.452 adds simple interest of 12 percent a year from the 31st day. Regence BlueCross BlueShield of Oregon, Providence Health Plan, PacificSource, Kaiser Permanente and Moda Health are the commercial carriers most Oregon practices contract with. We run Oregon claim queues with payer-segmented edits, CCO portal follow-up, and appeal letters written against the statute that actually governs the claim.
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The Oregon Billing Landscape
Oregon runs Medicaid through Coordinated Care Organizations: local plans that hold a global budget and are accountable for physical, behavioral and dental health together, an integration most states do not attempt. The Oregon Health Authority's CCO directory lists Advanced Health, AllCare CCO, Cascade Health Alliance, Columbia Pacific CCO, Eastern Oregon CCO, Health Share of Oregon, InterCommunity Health Network CCO, Jackson Care Connect, PacificSource Community Solutions in three regions, Trillium Community Health Plan in two, Umpqua Health Alliance and Yamhill Community Care. CareOregon is not itself a CCO — it administers Columbia Pacific CCO and Jackson Care Connect and partners in Health Share of Oregon — and that is exactly the distinction that misroutes an Oregon Health Plan claim. On the commercial side, Regence BlueCross BlueShield of Oregon, Providence Health Plan, PacificSource Health Plans, Kaiser Permanente and Moda Health are the carriers Oregon practices most often contract with, with the widest plan choice in the Portland metro. Oregon's prompt-pay statute is ORS 743B.450: an insurer pays a clean claim or denies it within 30 days of receipt, and if it needs more information it must ask in writing within those 30 days and then pay or deny within 30 days of the answer. ORS 743B.452 adds simple interest of 12 percent a year from the 31st day, and ORS 743B.287 bars balance billing for emergency services and for services delivered at an in-network facility. Providence, OHSU, Legacy Health and PeaceHealth are among the largest health systems, and rural and frontier communities in eastern and southern Oregon lean on telehealth and rural health clinics in a way the Portland market does not.
Who We Serve in Oregon
Our Oregon client mix skews toward solo practices, group practices, behavioral health practices , plus community health centers and telehealth providers. We work with providers in Portland, Salem, Eugene and across the rest of the state, all remotely.
Major Metros Served
What billing costs in Oregon
We publish one national rate card and bill Oregon practices on exactly the same terms as everywhere else — there is no regional markup and no quote-only tier below enterprise. You pay a percentage of what we actually collect, so if we do not collect, you do not pay.
| Practice size | Rate | Basis | Note |
|---|---|---|---|
| Solo practice | 7.0% | of monthly collections | Monthly minimum applies |
| Group practice | 6.0% | of monthly collections | Volume discounts available |
| Enterprise | Custom | tiered pricing | Scoped per engagement |
- No setup or implementation fee
- No per-claim charge
- No software fee and no markup on third-party costs — clearinghouse fees, postage and payer application fees are passed through at cost
- 12-month initial term, then month-to-month — 60 days' notice either way, no early-termination penalty
Payer Landscape in Oregon
Oregon Health Plan (OHP, managed through Coordinated Care Organizations - CCOs) routes members through Health Share of Oregon, PacificSource Community Solutions, Trillium Community Health Plan and 2 more plans, each with its own authorization rules and fee schedule. On the commercial side, Regence BlueCross BlueShield of Oregon, Providence Health Plan, PacificSource Health Plans drive the bulk of Oregon claim volume, so we maintain payer-specific denial playbooks and appeal templates for each. Claim clocks in Oregon run 365 days for Medicaid and 90-180 days for commercial payers — deadlines our A/R queues are built around. Oregon's prompt-pay statute: Oregon Revised Statutes 743B.450 requires an insurer to pay a clean claim or deny it no later than 30 days after receiving it, and where it needs more information to request that in writing within the same 30 days and then pay or deny within 30 days of receiving it. ORS 743B.452 adds simple interest of 12 percent per annum on the unpaid amount, accruing from the 31st day. Verified against the Oregon Revised Statutes chapter 743B text on 17 September 2026.
Medicaid Program
Oregon Health Plan (OHP, managed through Coordinated Care Organizations - CCOs)
Managed Care Organizations
Key Commercial Payers
Timely Filing Deadlines
Prompt Pay Law
Oregon Revised Statutes 743B.450 requires an insurer to pay a clean claim or deny it no later than 30 days after receiving it, and where it needs more information to request that in writing within the same 30 days and then pay or deny within 30 days of receiving it. ORS 743B.452 adds simple interest of 12 percent per annum on the unpaid amount, accruing from the 31st day. Verified against the Oregon Revised Statutes chapter 743B text on 17 September 2026.
Oregon Billing Regulations & Compliance
The Oregon Division of Financial Regulation sets the rules our Oregon billing workflows have to satisfy. Surprise billing in Oregon: Oregon's balance-billing statute is ORS 743B.287, first enacted in 2017 and amended in 2018 and 2022. An out-of-network provider may not bill an enrollee for emergency services, or for inpatient or outpatient services provided at an in-network health care facility. It does not displace in-network coinsurance, copayments or deductibles, and it does not apply to non-emergency services an enrollee chooses to receive out of network. The federal No Surprises Act applies alongside it. Telehealth parity: Oregon House Bill 2508 (2021 Regular Session, chapter 117) prescribes requirements for reimbursement of telemedicine services by the Oregon Health Authority and the Coordinated Care Organizations, and modifies the requirements for health benefit plan coverage of telemedicine. Confirm the modality and place-of-service rules with the specific plan or CCO before billing.
State Insurance Regulator
Oregon Division of Financial Regulation
Surprise Billing Protection
Oregon's balance-billing statute is ORS 743B.287, first enacted in 2017 and amended in 2018 and 2022. An out-of-network provider may not bill an enrollee for emergency services, or for inpatient or outpatient services provided at an in-network health care facility. It does not displace in-network coinsurance, copayments or deductibles, and it does not apply to non-emergency services an enrollee chooses to receive out of network. The federal No Surprises Act applies alongside it.
Telehealth Billing Parity
Oregon House Bill 2508 (2021 Regular Session, chapter 117) prescribes requirements for reimbursement of telemedicine services by the Oregon Health Authority and the Coordinated Care Organizations, and modifies the requirements for health benefit plan coverage of telemedicine. Confirm the modality and place-of-service rules with the specific plan or CCO before billing.
Common Questions
Common questions about medical billing services in Oregon.
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Get a Free Billing AuditHow does MedPrecision handle Oregon Health Plan CCO billing?
The Oregon Health Authority publishes the current CCO list, and it is longer and more regional than most payer tables assume: Advanced Health, AllCare CCO, Cascade Health Alliance, Columbia Pacific CCO, Eastern Oregon CCO, Health Share of Oregon, InterCommunity Health Network CCO, Jackson Care Connect, PacificSource Community Solutions in three separate regions, Trillium Community Health Plan in two, Umpqua Health Alliance and Yamhill Community Care. A common error is treating CareOregon as a CCO: it is not one. CareOregon administers Columbia Pacific CCO and Jackson Care Connect and is a partner in Health Share of Oregon, so a claim addressed to "CareOregon" has to be resolved to the right CCO for the member's county first. We confirm the CCO and its service area at eligibility check, then apply that CCO's authorization and submission rules.
Can MedPrecision support behavioral health billing in Oregon?
Yes. Oregon's CCOs are accountable for behavioral health alongside physical and dental care under a global budget, so behavioral health claims for an Oregon Health Plan member usually sit inside the CCO rather than with a separate carve-out vendor — but the authorization path and the covered code set still differ by CCO. We set the code and modifier rules per CCO and per commercial plan, and confirm the current policy with the plan before billing a new service line.
What should Oregon providers know about the state's prompt pay law?
The rule is ORS 743B.450, and it is a single 30-day clock, not a split between electronic and paper claims. An insurer must pay a clean claim or deny it within 30 days of receiving it. If it needs more information it must notify the enrollee and the provider in writing within those same 30 days, explaining what it needs, and then pay or deny within 30 days of receiving that information. A contract between an insurer and a provider cannot cut back the rights this section and ORS 743B.452 give the provider. We track claim timelines against that clock and raise complaints with the Oregon Division of Financial Regulation where a payer will not meet it.
Does MedPrecision support rural practices and telehealth billing in eastern Oregon?
Yes. Eastern Oregon Coordinated Care Organization covers twelve counties across the eastern half of the state — Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa and Wheeler — so for most Oregon Health Plan members in those counties the CCO is EOCCO, which makes payer-specific setup there worth doing properly once. We handle the telehealth place-of-service codes and modifiers each payer publishes, and verify a payer's current telehealth policy before billing rather than assuming last year's rule still applies.
What happens if an Oregon payer misses the prompt-pay deadline?
ORS 743B.452 requires an insurer that misses the ORS 743B.450 timelines to pay simple interest of 12 percent a year on the unpaid amount, accruing from the 31st day after it received the claim or received the additional information it requested. The interest is payable with the claim, and an insurer is not required to pay interest of $2 or less. We track every clean claim against that deadline, flag stalled payments in our A/R reports, and escalate to the Oregon Division of Financial Regulation when a payer defaults. Filing limits run on their own clock: Oregon's Medicaid provider guide allows 365 days from the date of service, while commercial limits are set by contract.
How do I choose a medical billing company in Oregon?
Prioritize a billing company that already works with Oregon Health Plan and the major commercial payers in Oregon — payer-specific edits and timely-filing windows are where most OR revenue leaks start. Ask about AAPC-certified coders, transparent pricing, and denial-rate and days-in-A/R reporting before you sign. Because billing is delivered remotely, a company's Oregon payer experience matters more than a local office address.
Services for Oregon practices
Specialties we bill for
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Services in Oregon
Specialties in Oregon
Other Locations We Serve
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