No Surprises Act Information

The No Surprises Act (NSA) is a federal law that went into effect on January 1, 2022.

The NSA protects insured patients from unexpected out-of-network bills for certain services. The NSA also protects uninsured or self-pay patients by requiring providers and facilities to give you a Good Faith Estimate of the cost of your care.

Good Faith Estimates for Uninsured and Self-Pay Patients

If you are uninsured or have insurance but do not wish to submit a claim to your insurance carrier, OAG is required by law to provide you with a Good Faith Estimate (GFE) of the estimated cost for your anesthesia items and services. The information below describes how you may obtain a GFE from OAG.

A GFE from OAG is for anesthesia professional services and is based on the information we are given by you or your surgeon’s office. The facility will bill you separately for the anesthesia drugs and equipment. The final charge will be based on the actual length of time of your procedure. It may differ from the GFE given to you.

Information We Need From You to Determine Your Good Faith Estimate

Before you call the OAG Quote Line, ask your surgeon’s office for the following information about your procedure. We can’t give you a GFE without this information:

  • Diagnosis ICD-10 Code(s)
  • Surgical CPT Code(s)
  • Estimated length of time for your procedure

What is this information?

  • Diagnosis ICD-10 Code: This code describes an individual’s disease, disorder, injury, and other related health conditions using the International Classification of Diseases (ICD) code set.
  • Surgical CPT Code: This code describes your medical or surgical procedure using the Current Procedural Terminology (CPT) code set.
  • Estimated length of time for your procedure: This is needed to calculate your GFE.

Call the OAG Quote Line for Your GFE once you have the needed information.

Phone Number: (503) 530-0872
Toll Free Number: (855) 514-4374
Business Hours: Monday–Friday | 8am–4pm Pacific Time

We will give you a copy of your GFE. The GFE can be emailed, mailed, or faxed to you. Let the Quote Line Representative know if you need to pick up your GFE in-person. GFEs may only be picked up at the OAG Corporate Office located in downtown Portland, Oregon after arrangements have been made for the pick-up.

Keep a copy of your GFE in a safe place or take a picture of it. You may need it if you are billed a higher amount.

Disclaimer

Your Good Faith Estimate (GFE) will show the costs of items and services that are reasonably expected for your anesthesia care. The estimate will be based on information known at the time the estimate was created. The GFE is not a contract and does not require you to obtain the items or services listed on the GFE. The GFE does not obligate OAG to provide such items or services to you.

The GFE does not include any unknown or unexpected costs that may arise during your procedure. This means you could be charged more if complications, special monitoring, or supplemental post-operative pain management is needed.

You may contact our patient billing office at (503) 972-7103 to let us know the billed charges are higher than your GFE. You can ask us to update the bill to match the GFE or ask if there is financial assistance available. If you receive a bill that is more than $400 over your GFE you can dispute the bill using the federal Patient-Provider Dispute Process (PPDR). To learn more about your right to a GFE or the PPDR, visit Know your rights without insurance | CMS, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

Balance Billing Protections for Insured Patients

The No Surprises Act protects insured patients from unexpected out-of-network bills from emergency room visits and non-emergency care related to a visit to an in-network hospital, hospital outpatient department, and ambulatory surgical center.

These protections apply to you if you have health insurance through an employer (including Federal Employees Health Benefits plan), the federal Health Insurance Marketplace, a State-based Marketplace, or other individual market coverage.

Out-of-Network Claims

OAG participates with most Oregon carriers and is currently working to establish contracts with Washington State insurance carriers. This process may take some time to complete. We want to assure you that OAG has processes in place to identify and handle claims that may process out-of-network. Any claim that processes out-of-network will be handled in accordance with the No Surprises Act and Washington State’s Balance Billing Protection Act.

Note that errors in processing can occur and OAG may be in network even if the claim processed out-of-network. We work with your insurer to address any processing errors.

If you have questions or concerns about a claim that is processed out-of-network, you may contact our patient billing office at (503) 972-7103.

Participating Insurance

Check OAG’s list of participating insurance companies to see if your plan is listed. We will update our listing as we finalize contracts with Washington State insurers.

Notice of Your Rights and Protections Against Surprise Medical Bills

OREGON
Please read Your Rights and Protections Against Surprise Medical Bills for more information. You may also visit Medical bill rights | CMS for more information.

WASHINGTON
Please read Your Rights and Protections Against Surprise Medical Bills and Balance Billing in Washington State for more information. You may also visit the Office of the Insurance Commissioner for Washington State’s website.

OAG Provides Good Faith Estimates

OAG Provides Good Faith Estimates

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