As a CareOregon provider, you may have some specific questions for us. Below, you’ll find contact and procedural information for providers. If you are looking for specific forms and policies, see Provider Forms and Policies.

Provider Support

Please call Provider Customer Service at 503-416-4100 or 1-800-224-4840.
Press option 3 for provider.

Care Management Department
Fax number: 503-416-3637 or 1-800-862-4831

Verifying Clinics’ E-mails
CareOregon is confirming clinics’ e-mail addresses to ensure that we can contact you with system alerts and other critical information. Please send the e-mail address(es) that you want CareOregon to use when contacting your clinic to careoregonalerts@careoregon.org. Be sure to identify each e-mail with job title and name.

Need to change your clinic info?
Send changes or updates to your clinic(s).
E-mail: ProviderUpdates@CareOregon.org 

Provider Relations Specialists
View our Team Assignments List to find your specialist.
Fax us at: 503-416-1478 or 1-800-874-3916

Becoming a CareOregon Provider 

CareOregon provides plan services to five Coordinated Care Organizations and offers two Medicare plans supporting and enhancing sensible, localized, coordinated care.

If you are interested in becoming a contracted provider please review our Credentialing Requirements for Primary Care Providers and Specialists.

If you have additional questions or would like to start the contracting process please contact Customer Service 1-800-224-4840 or 503-416-4100. Thank you for your interest in joining CareOregon’s provider panel!

If you have additional questions or would like to start the contracting process please email newcontractrequest@careoregon.org and include the following:

Provider Name or Clinic Name
Specialty
Phone Number
E-Mail  Address
Fax Number
Physical Address
NPI
TIN
DMAP ID #

Thank you for your interest in joining CareOregon’s provider panel!

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). Send CareOregon Advantage and OHP electronic claims to the same payor ID (93975). Do not bill separately for each plan.

For claim inquiries, you have several options:

  • Send your e-mailed claims inquiries to claimshelp@careoregon.orgNote: All emails containing protected health information (PHI) must be sent in a secured manner. We are unable to respond to e-mail that are not sent securely.
  • Call: 503-416-4100 or 1-800-224-4840. Press option 3 for Provider.
  • Provider Claim Appeal Form

Provider Portal Help


Oregon Health Plan Resources

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

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 using this form.

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.