Billing | Insurance | Assistance

Coquille Valley Hospital will submit claims directly to your insurance company for payment. Each time you visit, our registration personnel will ask you for your insurance information. Providing us with complete insurance information at the time of registration is critical for your account to be billed correctly.

Once all insurance payments are applied to your account, you will receive a statement notifying you of the balance you owe. Please note, some insurance plans take up to 90 days or more to pay a claim, and you will not receive a bill until after we have received your insurance payment. Patients are ultimately responsible for payment of their medical bills, regardless of insurance coverage.

Payment of all known deductibles, co-payments and services not covered by insurance are requested prior to pre-scheduled services being performed.

Insurance Plans And Cost-Sharing

We commonly bill the following health insurance plans on behalf of our patients. This list may change and may not include all the insurance companies we bill. Please verify with your insurance that our facilities and providers are in your network.

Aetna Commercial
Aetna Medicare Advantage
Advanced Health
Cigna Network
First Choice Network
Health Net
Health Net Medicare Advantage
Medicare
Medicaid/Oregon Health Plan
Moda Connexus Network
Moda Medicare Advantage
Moda Synergy Network
Pacific Source Commercial
Pacific Source Medicare Advantage
Providence
Regence Blue Cross/Blue Shield of Oregon
Regence Medicare Advantage
Tricare West
United Health Care
Veterans Choice Program (referral basis only)

Insurance Cost-Sharing

Your insurance will likely require you to pay a portion of the cost of your medical care. Typically, insurances use one of the following three types of cost-sharing.

  • Deductible: Patients pay a fixed dollar amount before the insurance will begin to pay a portion of covered services. Some insurances pay a different amount for facilities or physicians who are in network than for those out of their network. After the deductible has been met, you still may have a portion of the bill that you are responsible for paying.
  • Co-pay: Patients pay a fixed dollar amount that varies, based on the type of service. For example, you may pay $20 for an outpatient office visit and $50 for an emergency room visit.
  • Co-Insurance: Patients pay a fixed percentage of the cost. For example, you may pay 20% and the insurance company pay 80% of the allowed amount.

Paying Your Bill

We offer several payment options, including revolving payment plans and/or loan options to patients who are unable to pay their hospital charges in full.

Our payment options include the following:

  • Cash (in-person only), check, money order, and major credit card. Please note your encounter number on your payment.
  • Online, using quick pay.
  • Approved equal monthly payment plan, based on balance due.
  • Monthly payment plan offered through Access One Financial, subject to a minimum payment schedule and applicable interest for payment plans over 24 months.

For questions about billing, the Patient Financial Services Department is available to help Monday – Friday, 8 am to 5 pm by calling call 541-396-3101.

Financial Assistance

As a charitable organization, Coquille Valley Hospital offers financial assistance to patients who qualify. Depending upon each individual’s financial circumstances, all or part of the charges for services may be waived.

Patients who receive emergency, emergent, and primary care services who are uninsured or underinsured whose income is at or below 200% of the current year Federal Poverty Level are welcome to apply for our sliding fee discount program.  Coquille Valley Hospital offers a discounted/sliding fee schedule available based on family size and income. Discount details are available through our Patient Financial Services at 541-396-3101.

Patients who receive inpatient care, or other hospital services, or whose income is at or below 400% of the current year Federal Poverty Level are welcome to apply for our Financial Assistance Program (FAP).

Apply for assistance by completing and submitting a Financial Assistance Application (complete the form in Spanish here).

We do not discriminate in the provision of services based on an individual’s inability to pay, Medicare or Medicaid coverage, or with regard to race, color, sexual orientation or gender identity, national origin, disability, religion, or age.

Questions? If your last name starts with A-K, please call 541-824-1234. If your last name starts with L-Z, please call 541-824-1290.

For more information about our program, review the following documents:

Financial Assistance Policy
English | Spanish

Summary of Financial Assistance
English | Spanish

Billing and Collection Policy
English | Spanish

Payment Plans
English | Spanish

Plain Language Summary of Financial Assistance/Charity Care Policy
English | Spanish

Hospital Price Transparency

Price transparency can be confusing when it comes to healthcare. A major challenge is the hospital price for a service is not the actual out-of-pocket costs that patients will be billed after insurance payments, as each insurance coverage policy pays at a different rate.

In general, the patient’s out-of-pocket costs can involve several complexities that include;

  • The patient’s specific insurance plan and benefits.
  • Specifics negotiated between the hospital and the insurance plan.
  • The length of time spent in the hospital or facility, additional diagnostic tests, lab work or necessary procedures.
  • Any other unforeseen conditions or circumstances that arise during your care or recovery.

Insured Patients

Patients with insurance coverage should contact their insurance provider directly to get the most accurate out-of-pocket cost estimates. Your insurer can help you understand your benefits, co-payments or deductible requirements which are important for accurately determining the estimate of your costs.

When reviewing charges, please note actual payment rates for hospital care provided to insured patients are:

  • Negotiated with health plans.
  • Set by the federal government for Medicare.
  • Set by state government for Medicaid.

Uninsured Patients

At our hospital, all patients will be treated fairly and with respect during their treatment and regardless of their ability to pay for the services they receive.

We offer a discount for patients who do not have health insurance coverage. In addition, uninsured patients may be eligible for financial assistance through our Financial Assistance Program. Patients without insurance will be offered reasonable payments and payment schedules and, subject to their acceptance offer, will be billed at discounted local market rates. Our staff provides application assistance for both Hospital Presumptive Eligibility and standard Oregon Health Plan (OHP) programs.

We are committed to providing price information to our patients. Coquille Valley Hospital provides individualized cost estimates for all services, upon request.

No Surprises Act

Starting January 1, 2022, consumers will have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs will be restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network.

Currently, if consumers have health coverage and get care from an out-of-network provider, their health plan usually won’t cover the entire out-of-network cost. This could leave them with higher costs than if they’d been seen by an in-network provider. This is especially common in an emergency situation, where consumers might not be able to choose the provider. Even if a consumer goes to an in-network hospital, they might get care from out-of-network providers at that facility.

In many cases, today the out-of-network provider can bill consumers for the difference between the charges the provider bills, and the amount paid by the consumer’s health plan. This is known as balance billing. An unexpected balance bill is called a surprise bill.

For more information please visit https://www.cms.gov/nosurprises for federal regulations and/or https://dfr.oregon.gov/news/2018/Pages/20180301-balance-billing.aspx for state regulations.

CMS-10791 – 1. Right to Receive a Good Faith
CMS-10780 – Model Disclosure

Chargemaster

A chargemaster is intended to offer users an estimate for commonly provided healthcare services pursuant to the CMS Price Transparency Final Rule (84 FR 65524) effective January 1, 2022. The following pricing is only an estimate and cannot be relied upon as a quote or guarantee of actual charges. Your actual charges may vary based on your treatment and individual healthcare needs. Insurance coverage is not guaranteed. Please consult with your health insurer to confirm your individual payment responsibilities and remaining deductible balances. You will be held solely responsible for all actual charges incurred by you and/or your insured dependents.

The following pricing is accurate as of 4/20/2024 and is subject to change:

Coquille Full Charge Description Master Price Transparency
Coquille Shoppable Price Transparency

Release of Information Forms