For copies of your Billing Record

For Patients
If you would like a copy of your OAG billing records for yourself or to send to another person or company, free of charge, please call our billing office at (503) 278 5354 or toll free at (855) 514-4375. You may also send us a letter requesting a copy of your OAG billing records. If you send a letter, please 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. How you would like your billing records sent, and to whom you want them sent:
    • If by mail, please include the delivery address;
    • If by fax, please include the fax number; or,
    • If by secure email, please clearly write the email address.
  5. The requesting person’s name, signature, and date;
  6. The requesting person’s relation to the patient (e.g., self, parent, personal representative);
  7. If you are a personal representative 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., car insurance company, etc.), and are initiating a request for a patient’s OAG billing records, please download the Authorization Form below and have the patient complete it. Please note that OAG charges a flat fee of $30 to process requests from third parties.

Authorization Form (PDF)

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

PLEASE NOTE: OAG maintains patient billing records for both OAG and Interventional Pain Consultant (IPC) patients. Patients requiring copies of their IPC medical records click here. Patients requiring copies of their anesthesia medical records should request them through the facility where they received medical services.

BEFORE SENDING AN EMAIL, PLEASE NOTE:

Do not include personal health information in this email. Information sent via email should not be considered secure.