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Due to state and federal policy, we cannot provide care to those who have primary coverage from the Oregon Health Plan or Medicaid. We can provide care to those who have TRICARE coverage, but you will be responsible for the full cost of the visit at checkout.
ZoomCare is not in-network with any EPOs or HMOs. If you have an Exclusive Provider Organization (EPOs) or Health Maintenance Organization (HMOs) plan you can get care at ZoomCare but you will be responsible for paying the visits costs in full. Contact your insurer for more information.
To bill your employer's workers' compensation insurance when scheduling your visit:
1. Schedule a visit online or with our apps for iOS and Android.
2. When asked "How will you pay?" select "Workers' Compensation."
3. Enter your manager's name and phone number when prompted.
4. ZoomCare will collect the rest of the information needed from you when you arrive for your visit.
Note: Your employer cannot pay for your visit using their personal or business credit or debit card. In Oregon, ZoomCare must be the first place you get care for your injury or illness. We're not able to bill worker's compensation if you've started your care and a claim with another healthcare provider.
Understanding the cost of your visit is linked to your specific insurance coverage. Some plans will cover a portion of care, while others may cover it fully. Most of our visits are billed as primary care, though some services—such as ZoomCare Specialists and ZoomCare Super Clinics—bill as specialist care. We realize insurance can be confusing, so we recommend calling the number on your insurance card for a clear explanation of your financial responsibility. It's also important to note that the type of visit you choose can impact your coverage. When discussing your needs with your provider, specify the service you require for the most accurate information. It may also be helpful to clarify what your deductible and copays are.
A deductible is a fixed amount you are responsible for paying each year before your health insurance benefits begin to cover the full amount. After meeting a deductible, you typically pay a coinsurance or copayment (a percentage of the costs) for any services that are covered by your plan. You will continue to pay coinsurance until you meet the out-of-pocket maximum for the year.
A copay, short for copayment, is the fixed amount you pay for a covered health service after you've paid your deductible. The remaining balance is covered by the patient's insurance company. Copayments can vary for different services within the same plan, like drugs, lab tests, and speciality visits. Generally, plans with lower monthly premiums have higher copayments. Plans with higher monthly premiums usually have lower copayments.
ZoomCare makes every attempt to verify a patient's insurance benefits before the visit. There may be times when we are unable to gather a status of your coverage from your provider. For example, your insurance information may be inaccurate or out of date, or the insurance company’s eligibility system may not respond. If your insurance company isn’t able to verify your benefits, we’ll collect nothing at your visit except the cost of prescriptions. Once your insurance company has processed the claim, we'll collect your portion of the bill. This process typically takes 30 to 45 days.