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The Professional Claim Instructions handbook is designed to help those who bill the Oregon Health Authority (OHA) for Medicaid services submit their claims correctly the first time. +'?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/Reporting.aspx' There are two types of claim review: One type is a suspense (suspended) claim, and the other is a financial hold. The federal Department of Health and Human Services expects to distribute approximately $15 billion to eligible Medicaid/CHIP providers who have not yet received a payment from the Provider Relief Fund General Distribution.
Need to find out if you are on Oregon's list of Medicaid organizations and providers? Medicaid Electronic Health Records Incentive Program Manuals and Other Resources Oregon Health Plan For matters of this manual, all members of a CareOregon-affiliated health plan (CCO or Medicare) will be referenced as “CareOregon members.” The Oregon Health Plan and coordinated care organizations (CCOs) The Oregon Health Plan (OHP) is the Oregon Medicaid program administered by the Oregon Health Authority (OHA). +'?ID={ItemId}&List={ListId}'); return false;}}, null); June 2017.

Forms change and are updated here on a regular basis, so please be sure to return to this page for the most up to date forms and policies. Providers: Apply for federal Provider Relief Fund payments by Sep. 13, 2020.

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This manual has information on the following topics:



Providers: Apply for federal Provider Relief Fund payments by Sep. 13, 2020. '/_layouts/15/expirationconfig.aspx' Log into the Provider Web Portal: Available 24 hours a day, 7 days a week https://wwww.or-medicaid.gov » '/_layouts/15/expirationconfig.aspx' Physical Health Providers can download the CareOregon Provider Manual. +'?ID={ItemId}&List={ListId}'); return false;}}, null);Registration, technical assistance for electronic data interchange (EDI) trading partnersBecoming an OHP provider or updating your informationFee-for-service medical and dental prior authorization requestsNurse advice, and information about available providers, for members not in an OHP medical planDetermining OHP coverage for specific condition / treatment pairsOHP Code Pairing and Prioritized List Hotline - 800-336-6016 (option 4) or 503-945-5939Complex billing questions, appeals and requests for claim reconsiderationFee-for-service pharmacy prior authorization requestsDHS|OHA Electronic Funds Transfer (EFT) Coordinator - 503-945-6872javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+

+'?ID={ItemId}&List={ListId}'); return false;}}, null);javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+ +'?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+

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