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 Young Woman Contemplating

Why didn't my insurance pay?!

We send a claim to the insurance plan according to their instructions collected during your initial benefits check and price estimate.  We confirm that the insurance company received the claim for processing and we confirm that the insurance acknowledges it as a clean claim (ie: free of errors).  Oregon law requires insurance payers to respond to claims within 30 days.  If your insurance has confirmed receipt of your clean claim , but hasn't paid the claim, they may reconsider with a patient appeal.  Insurance plans may not be able to provide the provider's office or the billing office with the information or the ability to get an unpaid claim reprocessed.

Mountain Ridge

What Do I do Next?

What next? …

  • You can use your insurance company’s online member center/ portal tool to follow up.  This tool varies by region and by company.  

  • You can call the phone number on the back of your insurance card.  The number for “Member Services” or “Customer Service” will likely be the most direct number.  Follow the prompts to speak with Customer Service or Member Services.

  • We recommend watching the 5-minute You Tube video linked here for some basic information about insurance before you get started: 

Patient Resources for Insurance Appeals

More Resources

Brass Clock

Prompt Payment

Image by Josh Appel

Interest on Unpaid Claims


What is a Clean Claim?

Judge and Gavel

Transaction Standards

Stack of Books

Appeals Guide

Division of Financial Regulation - Consumer Advocacy Hotline: (888)877-4894
Division of Financial Regulation Email:
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