Statewide Healthcare RCM Coverage • 425 Cities & Towns
Medical Billing & RCM Services in Oregon
Delivering tailored medical coding, billing, and credentialing services across Oregon. Serving healthcare providers, clinics, and hospital groups with an exceptional 98% clean claim rate.
Statewide Regulatory & MAC Compliance Hub
Oregon Medicare MAC Jurisdiction & Payer Regulations (J-F)
Comprehensive Part A/B Medicare contractor policies, LCD standards, and state Medicaid filing rules for Oregon medical practices.
98.2% First-Pass Clean Claim Rate
Medicare Administrative Contractor (MAC)
J-F
Jurisdiction F (J-F)
Contractor:
Noridian Healthcare Solutions, LLC (HQ: Fargo, ND)
State Medicaid & Public Health Agency
OR
Oregon Health Authority (Oregon Health Plan / OHP)
Governing Agency:
Oregon Health Authority (OHA)
Medicaid Timely Filing:
365 days from Date of Service / 90 days from Medicare RA
Medicare Timely Filing Window
12 months (365 days) from Date of Service
First-Level Appeals (Redetermination)
120 calendar days from Remittance Advice (Redetermination)
First-Pass Clean Claim Target
98.2% Scrubber Rate
Active Local Coverage Determinations (LCDs) in Oregon (J-F):
4 Active LCDs
L38397
MolDX: Molecular Testing for Oncology and Infectious Disease
L38765
Facet Joint Injections & Denervation
L33767
Hyaluronan Injections for Osteoarthritis of the Knee
L34177
Non-Coronary Vascular Stents & Angioplasty
Regional Billing Nuances & Compliance Safeguards:
Alaska GPCI Frontier Floor: Protected under statutory GPCI floor adjustments (ACA § 10324), resulting in higher Medicare Part B work units.
Critical Access Hospital (CAH) Method II Billing utilized throughout MT, WY, ND, SD, and ID (UB-04 Revenue Code 096X/097X with Attending NPI).
State Medicaid coordination (AHCCCS in AZ, Apple Health in WA, OHP in OR) requires exact provider ID cross-walks on COB files.
Mandatory single-use drug vial wastage recording with JW/JZ modifiers.
Healthcare Locations & Cities in Oregon
Select your city below for specialized local medical billing solutions and regional payer expertise.