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Provider Policy Change: 3/1/2025 Removal of Provider Reconsiderations.

Metro area behavioral health providers

Attention: All behavioral health requests should be submitted via the CareOregon Connect portal

We understand at times there may be a need to submit via fax and we will allow this as an exception when indicated. If you do not have access to the Connect portal and need to submit a request, please contact CareOregon Provider Customer Service at 800-224-4840 (option 3) to request an exception form and to obtain assistance with Connect access.

Guidelines for serving members 

Best practice guidelines are intended to ensure appropriate and consistent utilization of mental health and SUD services and to provide a frame of reference for providing service to CareOregon/Health Share members. You can view these standards and guidelines by referencing the resources below. 

Documentation Standards for the following provider types are available upon request by emailing cqssupport@careoregon.org:

  • Mental Health Outpatient (please identify if you hold a Certificate of Approval with Oregon Health Authority)
  • Outpatient Substance Use Disorder Providers
  • Youth Intensive In-Home Behavioral Health Treatment (IIBHT) providers

Provider portal

To access CareOregon’s secure provider portal, including logins, signups and portal tutorials, visit our Provider Portal webpage by clicking the button below. 

Payments

To ensure access for our members, CareOregon pays both qualified in network and out-of-network providers for authorized behavioral health services provided to CareOregon/Health Share members. To learn more, visit our BH Qualified Directed Payments (BH QDP) web page.


CareOregon Behavioral Health System Integration (BHSI)

In 2023, CareOregon will transition Metro behavioral health claims and authorization administration from CIM/PH TECH to CareOregon’s internal operating systems. Read the full announcement in the CareOregon system integration update.

We will be providing the latest news and information on the transition at the BH Billing and Admin Meetings.

We want to hear from you! Submit your questions through the provider question form.

Training for the CareOregon Connect Portal

In preparation for the October 1st, 2023 Connect system go-live, CareOregon’s Provider Relations (PRS) team hosted several educational training sessions on how to navigate the Connect Portal for Behavioral Health. Check out the resources below!

More behavioral health resources

Please carefully review all procedures before rendering any services to members. CareOregon’s policies, procedures and authorization requirements are described above in “Guidelines for serving members.” You also may find additional resources for doing business with CareOregon in the tabs located below.  


For more detailed information on claims, authorizations, data reporting and other topics, please see the  Behavioral Health Provider Manual.

All behavioral health requests should be submitted via the CareOregon Connect portal

We understand at times there may be a need to submit via fax and we will allow this as an exception when indicated.
If you do not have access to the Connect portal and need to submit a request, please contact CareOregon Provider Customer Service at 800-224-4840 (option 3) to request an exception form and to obtain assistance with Connect access.

Utilization management resources: 

ACT/ICM 

For information on where to send claims, how to sign-up for EFT or electronic remittance, and other claim inquiries, please refer to the "Submitting claims and receiving payment" section of our Provider Support page.

 

For more detailed information on claims, authorizations, data reporting and other topics, please see the Metro Area Behavioral Health Provider Manual

  • Contracted providers may register as a new provider and gain CIM access by visiting the PH TECH Help Center at help.phtech.com and submit a request. (Learn more here.)
  • Contracted providers may visit theCIM Provider Portal to log in to your CIM account and access additional CIM provider tools, like the CIM Provider Manual.
  • For additional support, please contact PH TECH Provider Customer Service at 503-584-2151

Please ensure you request and activate your EFT registration codes with Payspan

 



Contact us

BHSI Transition

See details for who to contact regarding services provided before and after 10/01 in our BHSI Who to contact for help? quick guide (pdf)

Provider Portal

For most needs, we recommend using CareOregon Connect, our online provider portal. This includes topics such as, but not limited to, submitting authorization requests, reviewing authorization and claim status, viewing/retrieving remittance advice, requesting PCP changes, viewing member rosters and member eligibility.   

Provider Customer Service 

Reach out to our Provider Customer Service Team at 800-224-4840 (option 3) for questions regarding the online provider portal, billing and authorization inquiries, claim and authorization appeals, general CareOregon guidelines and questions that the portal cannot answer.

Provider Relations Specialist

If you have further questions, you can contact the provider relations specialist assigned to you.

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