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What to Do If You Get a Bill for Covered Services

If You Get a Bill for Services that the Oregon Health Plan (OHP) or Your Private Health Insurance Should Cover:

Don't pay it yet! First make sure your providers know to bill OHP or your private insurance.

Note: If you signed an Agreement to Pay for services that OHP does not cover, you do have to pay the bill. These steps apply only to services that OHP covers. Your providers must tell you whether services are covered by OHP before they give them to you.

Take these steps right away:

​Note all the health coverage you had at the time of your visit, including your OHP. Give the provider's office all your ID numbers, including your Oregon Health ID, CCO member ID and private health insurance ID. Ask staff to bill these resources. ​

​State your Oregon Health ID number. Say that a provider is billing you for a service that OHP covers.

  • If you have private insurance, also tell your insurance company about the bill. They will help you get the bill paid.
  • If asked, be ready to send a copy of the bill to your CCO, OHP or your insurance company. 

​If you have a CCO or private health insurance:

You can appeal the decision. To do this, call or write to your CCO or insurance company.

  • Find your CCO's address on its website or your member ID card. Find CCO websites and contact information.
  • If you have private health insurance, check with your insurance company about its appeal process.
  • Tell them you do not agree that you need to pay because you had OHP at the time. Ask them to review the decision again.
  • Keep a copy of the appeal, or note the date and time you called the CCO to ask for an appeal. Keep a copy of the medical bill(s) with your appeal for your records.

If you do not have a CCO or private health insurance:

Write OHP at P.O. Box 14015, Salem, OR 97309.  You can also email Client Services or call 1-800-273-0557 (Monday through Friday, 8 a.m. to 5 p.m. Pacific Time).

Y​our CCO, private health insurance or OHP will tell you if you need to pay the bill. If they tell you that you don't need to pay, call the provider to make sure they know.​

If You Get Papers from a Court or Collection Agency:

Please follow steps 1 through 4 above. Your CCO can help with collection agency bills. Be ready to tell them:

  • The provider's name,
  • The patient's name and CCO member ID number, and
  • The date the service was provided.

You also may call a lawyer or the Public Benefits Hotline at 800-520-5292 (TTY 711) for legal advice and help. There are consumer laws that protect you when you are wrongly billed while an OHP member.

If You Want to Privately Pay for Covered Services:

If you ask to pay privately for a covered service, you are responsible to pay if these steps were completed before you received the service. The provider cannot bill your CCO, OHP or other payers for any services you pay for under this agreement.

  • ​The service is covered.
  • Who covers it (OHA, your CCO/plan, or other payer).
  • The provider would be paid in full for the service.
  • The estimated cost of the service, including all related charges.
  • The amount the provider would be paid for the service.
  • The provider cannot bill you for more than the amount paid.

​This agreement must:

  • List the information your provider told you about the service.
  • State that you got to ask questions, get more information, and ask your caseworker or client representative about the service.
  • Say that you agree to privately pay for the service.


Member Resources

OHP contacts

Words to know

Member Billing Rules and Laws

Oregon Revised Statute 414.066 says that providers must not bill members for services. 

Oregon Administrative Rule 410-120-1280(4-5) explains when providers can and cannot bill members for services.

To Learn More:

Read your OHP member handbook.


We want to make sure you have the information you need. 

 Call 1-800-273-0557

Talk to your CCO

  Email us