Provider updates

What?

CareOregon will be transitioning Metro behavioral health claims and authorization administration from CIM/PH TECH to CareOregon’s internal operating systems in 2023. This Behavioral Health System Integration (BHSI) project will be one of our key focus areas with you, our provider partners, for this coming year.

Several of your current processes will be impacted by this change including eligibility, authorization, claims, payment, and reporting. 

These processes will be moving out of PH TECH and into CareOregon’s provider portal (Connect) and claims system (QNXT). Additional specifics are coming soon. 

When?

The transition is planned to be completed by the end of 2023. The current estimated date for the new system to be live is October 1, 2023. The system build and testing work is well underway. Timing and future dates are dependent on results of this work and will be finalized and communicated as soon as possible. Be assured that we will allow ample time for provider input, testing and training. Your success equals our success!

Why?

This transition will improve coordination and efficiency. The move will bring our claims data together and support the whole-person view (physical health AND behavioral health) of your clients/our members. It will eliminate parallel work streams, provide a better cross-regional experience for you, and enhance the notification and authorization processes.

How?

We recognize that with change comes some initial work. We plan to have robust support and training to ensure you are ready for the move. We will work closely with you to understand and mitigate risks before we transition to the new system.

Providers will receive training on the new tools and processes along with support throughout the transition.

To get things started and allow you and your teams to hear from us directly, we will host a BHSI Provider Partner Town Hall in the Billing and Admin Workgroup Meeting scheduled for February 23.  If you have not previously participated in this workgroup and would like to attend this February 23 session, please submit your email using this online form.  An invite will be coming soon. 

What to expect:

• Monthly network updates: Dates, plans, training, and updates
• Q & A opportunities
• A dedicated CareOregon webpage with up-to-date transition details

If you have immediate questions that need to be addressed, please submit them using this online form. Questions submitted will inform future online resources and provider communications. Questions will also be taken during the upcoming town hall.

Thank you!