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Physical health providers

Provider Manual

The CareOregon Provider Manual can be used by CareOregon/Oregon Health Plan and CareOregon Advantage/Medicare contracted providers. The manual has information on the following topics:


  • Membership
  • Benefits
  • Referrals and authorizations
  • Billing and payment
  • Interpretation
  • Transportation for OHP members
  • Provider Relations Specialists
  • Primary care
  • Medical records
  • Quality improvement
  • Credentialing
  • Medicare Advantage
  • Clinical practice guidelines

Provider Portal 

To access CareOregon Connect, visit our Provider Portal webpage. 

More resources

For information on other resources, select a topic below. 

This section includes CareOregon’s medical policies, forms and medical management guidelines.

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.

 

Eligibility

Use the provider portal to verify a member’s eligibility with CareOregon.

 

Authorization guidelines

Changes are posted on the 15th day of the calendar month (or the next business day).

 

CPT code grid: Diagnostic and treatment procedures

 

DME: Authorization and code lists

 

Frequently asked questions (FAQs)

Authorization request forms

 

Medicare behavioral health policy and form

  • Admission Through Discharge Checklist

 

Miscellaneous policies and forms

2023 Metrics toolkit

2022 Metrics Medicaid Toolkit 

    More resources

    Contact us

    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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