Electronic HIPAA Transactions

CareOregon is pleased to support the American Medical Association’s (AMA) "The Heal the Claims Process” Campaign, which is designed to help physician practices streamline their claims processing through the use of electronic health care transactions. The AMA recognizes electronic health care transactions as a cost saving, efficient way to do business and allows physicians to refocus resources on patient care.

The links below provide information regarding various electronic transactions such as submitting claims, receiving payments and remittance advices.

To access your Remittance Advice electronically:



To receive payments via Electronic Funds Transfer (EFT):
  • EFT-PDF_Form - Please complete and fax back to the number listed on the bottom of the form.

To receive Electronic Remittance Advice:

 

To submit Claims electronically:
  • To submit claims electronically use the same EDI Payer ID #93975 for all CareOregon entities (CareOregon Dental, CareOregon Advantage and CareOregon Medicaid claims). Do not bill separately for each plan.
  • For EDI claims where additional paperwork or documentation will be submitted, complete this form and indicate submission in the PWK segment (Loop 2300). 
  • Contact your practice management system vendor or clearinghouse to initiate electronic claim submission. CareOregon accepts HIPAA-compliant 837 electronic claims through our clearinghouse, Change Healthcare. Change Healthcare will validate the claims for HIPAA compliance and send them directly to CareOregon. Change Healthcare offers several solutions for providers without a practice management system or clearinghouse, contact them at 1-866-369-8805 for medical claims and 1-888-255-7293 for dental claims.
  • 837 Frequently Asked Questions regarding EDI billings and 5010 transactions

 

Helpful Links

 


Questions?
Contact your Provider Relations Specialist