Provider Resources

In this section, we have grouped information that CareOregon Providers may find useful. If you are looking for specific forms and policies, see  Provider Forms and Policies


ICD-10 FAQs



CMS Fraud, Waste and Abuse Training

  • Training documents can be found here
  • CareOregon takes fraud, waste and abuse very seriously. If you suspect that benefits aren't being used correctly or want to report a case of waste, abuse or fraud, please contact Ethics Point at 1-888-331-6524. You also can file a report online at www.ethicspoint.com.


Clinical Quality Metrics Toolkit



Information on Filing Claims and Pricing

See Also:

 

How to Submit Claims

When submitting claims to CareOregon, you have several options:

  • Send claims electronically using our payer ID 93975, please contact Emdeon for more information at 1-877-363-3666.
  • Mail paper claims to:
    Claims, CareOregon
    PO Box 40328
    Portland OR 97240

 

Please note:

Send electronic claims to payer ID (93975).

For claim inquiries, you have several options:

 

Provider Portal Help

 

Oregon Health Plan

MMIS (OHP Provider Web Portal)
OHP Web Portal Training
Sign up for OHP Updates

 

Oregon Health Authority Primary Care Provider Attestation

The Centers for Medicare and Medicaid Services (CMS) announced that practitioners who meet their new definition of primary care provider would see an increased Medicaid reimbursement rate for two years. Providers who bill CareOregon can now complete the self-attestation form on the State’s website in order to begin receiving the increased reimbursement rate.

CareOregon is basing its increased reimbursement rate on the attestation provider file issued by the Division of Medical Assistance Programs. Providers who qualify must complete the self-attestation form on DMAP’s website in order to receive the increased reimbursement rate.
 

Electronic Data Interchange (EDI)

Reduce paper, save time, and get claims filled more quickly! Use the Oregon Health Plans’s EDI to expedite processing.

 

Verifying Clinics’ E-Mails

CareOregon wants to ensure that we can contact you with system alerts and other critical information. Please send your primary contact E-Mail address(es) to careoregonalerts@careoregon.org. Please identify each E-mail address with corresponding name and job title.


 

Other Provider Community Resources

Oregon SafeNet is the statewide, toll-free helpline for health and social service information. Many community providers, service agencies, and individuals use SafeNet to locate free or low-cost services statewide in a variety of languages.  Provide information about your flu clinic or other events.

OneHealthPort provides free, secure access to participating Oregon Health Plan and other payor administrative web sites through a single login process, launching 2011. Click here for more information about OneHealthPort Oregon.