Insurance & Billing
Contracted Commercial Insurances
- First Choice Health Network
- Health Net Health Plan
- Pacific Source
- Partners Direct Health
- Providence Health Plans
- Regence Blue Cross Blue Shield
- United Healthcare
Contracted Medicare Advantage Plans
- Aetna Medicare
- AgeRight Advantage
- AllCare Advantage
- Atrio Medicare
- Wellcare by HealthNet Medicare Advantage
- Regence MedAdvantage
Grants Pass Clinic bills almost all insurances for our patients, but please keep in mind that not all insurances are contracted with Grants Pass Clinic. The companies listed above have entered into agreements with the Grants Pass Clinic. This means we are on their list of participating providers for certain products or health plans that they offer. Grants Pass Clinic does not necessarily participate in all of the products they offer, so you will need to check with your insurance company’s member benefits office to determine if we are covered as a participating provider for your specific benefits plan.
What if my insurance isn’t contracted?
Many of our patients have coverage through companies with whom we do not have a contract. As a courtesy, we submit claim information to your insurance carrier for processing; however, you remain responsible for the payment for those services. We hold the insurance pending amounts in suspense to provide adequate time for processing by your health plan and then transfer any remaining portions over to your personal account after the insurance payments have been processed.
What if my insurance doesn’t pay right away?
Our contracted insurances are required by Oregon law to pay all “clean” claims within thirty days. Unfortunately, there is no such requirement on non-contracted insurances. We bill these insurances for you as a courtesy, and will wait a reasonable amount of time for your insurance to settle the claim. Most insurances settle these claims in 30-60 days. In any event, if your insurance has not settled the claim within 90 days, the balance is then transferred to your personal account and is considered due and payable by you at that time.
How can I help speed up my insurance company’s processing?
First, make sure we have complete and up to date billing information for you, including any employment or insurance coverage changes. If you have had any recent changes, please call our office and make sure we have the correct information for submitting bills to your insurance.
You can also help by communicating directly with your insurance company. Most insurance companies issue an Explanation of Benefits (EOB) within 30 days of receiving our bill. If you haven’t received an EOB within that time frame, consider calling your insurance company’s member services number and ask them about the status of your claim.
Promptly complete and return all forms to your insurance company when they request information. Insurance companies will withhold payments if they are waiting for information from you. If your insurance has sent you a form requesting information such as other coverage or accident information, you need to promptly complete and return the form so they can continue processing your claim.
If you have any questions concerning our handling of insurance billings, please contact our Business Office at 541-472-5580.
Billing and Credit Policies
All of us at Grants Pass Clinic recognize that the costs of medical care can pose significant challenges to some of our patients. Not all patients have insurance coverage, and those that do are increasingly finding they are personally responsible for a larger share of the cost.
It has been our long standing policy to work with patients, as needed, to make financial arrangements that are reasonable and mutually beneficial.
If you have insurance, we will file your claim and wait a reasonable time period for your insurance to pay. Once processed by your insurance, or after ninety days, remaining balances are transferred to your personal account and considered due and payable in full.
Upon approval by the credit office, monthly payments may be arranged to settle your account balance. The minimum monthly payment for balances of $250, or less, is $25. If your current balance is greater than $250, then we require a monthly payment of 10% of the total balance. For example, a $450 account balance requires a minimum monthly payment of $45. These payments are in addition to any co-pays you may incur for future appointments.
We partner with Resolution Resource to assist with your month-to-month payment plans.
Not all services are available on a credit basis and some services may require all or partial payment in advance.
What happens if my account is delinquent?
It is important that you maintain your account in good standing. Payments need to be made regularly and consistently. Failure to maintain your account could result in it being turned over to an outside collection agency. Should it become necessary for us to turn your account over to a collection agency, it is Grants Pass Clinic’s policy to notify you that you will not be provided any further medical services at our clinic.
Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. Click here to read notice.
Good Faith Estimate
Patients who don’t have insurance have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Click here to read notice.