For copies of your Billing Record

For Patients
If you would like a copy of your itemized billing statement for yourself or to send to another person or company, please send us a letter and include the following information:

  1. Patient’s full name
  2. Patient’s date of birth
  3. Date(s) of service or date range of the billing records you want
  4. Purpose of your request (e.g., personal use, physician, attorney, court, etc.)
  5. Delivery address
  6. Patient’s account number, if known
  7. The requesting person’s name, signature, and date
  8. The requesting person’s relation to the patient (e.g., self, parent, personal representative)
  9. If the personal representative is signing the letter on behalf of the patient, please provide a description of your authority to act on behalf of the patient and a copy of official documentation granting this authority.

For Third Parties
If you are a third party (e.g., attorney’s office, car insurance company, etc.) and are initiating a request for a patient’s billing records, please download the Authorization Form below and have the patient complete it.

Authorization Form (PDF)
Authorization Form (Word)

Where to Send Your Request
You may send your letter or completed Authorization Form to the OAG Corporate Office in one of the following manners:

By Mail:
OAG – Compliance Department
707 SW Washington St., Suite 700
Portland, OR 97205

By Fax: (503) 295-2232
Attention: Compliance Department

Questions about requesting OAG billing records may be directed to the OAG Corporate Office at (503) 299-9906.

PLEASE NOTE: OAG billing records are processed by Medac, OAG’s billing vendor. Medac charges a fee for billing record requests initiated by third parties. 

Your Bill Explained

We recognize that you may have questions about your bill following your procedure. Let our billing partner, Medac, help you understand the billing process.

Toll-Free (855) 514 4375 LEARN MORE

Insurance Plans

If you have insurance and would like an estimate of the insurance allowable, contact the OAG office for a quote.

Quote Line(855) 514 4374



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