Provider Web Portal

This page contains information on how Oregon Health Plan (OHP) providers can use the new Provider Web Portal at https://www.or-medicaid.gov. The Provider Web Portal will provide free, real-time information over the Web. It will be available 24 hours a day, 7 days a week, excepting regularly scheduled down time on the weekend.

• Initial setup
• Account administration
• Eligibility verification
• Client benefit and HSC List information
• Prior authorization
• Billing and adjustments
• When you need help
• Training

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All Web portal functions are described in the Provider Web Portal Handbook (PDF). Prepared for 2008 statewide MMIS implementation training, this book provides information about all the Web portal functions.

Use the following resources to learn how to do business with DHS using the Provider Web Portal. You will need the free Adobe Acrobat Reader to view these documents. If you do not already have the latest version of the Acrobat Reader on your computer, you can download it now.

Initial setup 

Access to the Provider Web Portal is for authorized DHS provider types. You just need the Personal Identification Number (PIN) letter issued by DHS, your DHS provider ID, and access to the Internet. If your provider type is eligible for National Provider Identifier (NPI), you must register your NPI with DHS in order to access Web functions.

You do not need to complete a DHS Trading Partner Agreement. If you have a Web portal administrator in your office, that person can give you access to the Web portal. If you do not have a Web administrator in your office and lost or did not receive a PIN letter from DHS, contact Provider Services.

• Initial Setup Guide (PDF): Who gets a Web portal account; suggested workflow; how to setup your account; step-by-step instructions; login assignment form; sample error messages
• Account setup tutorials (PowerPoint) or (PDF)
• One-page quick reference (PDF): How to set up Web portal accounts and how to verify eligibility.
• Login assignment list (Word) or (PDF): Use this list to help you keep track of the clerks you need to add to your Web portal account(s).
• Web basics (PDF): System requirements, general tips, how to find online help

Account Administration

If you can only see the Eligibility menu on your Web portal menu bar and want to have access to other functions such as Claims, Plan of Care, Prior Authorization, and HSC List Inquiry, contact your office's administrator. That person needs to update your clerk role to give you access to new functions.

• Account Administration Guide: Login and logout, clerk maintenance, account updates. NEW
• Clerk setup and maintenance tutorials (PowerPoint) or (PDF) 

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Eligibility verification

Providers must verify eligibility using Automated Voice Response (AVR) or the Eligibility Verification screen of the Provider Web Portal. For copayment information, you will need to use the AVR.

• Eligibility Verification Guide (PDF): How to read the Web portal eligibility verification screens
• One-page quick reference (PDF): Where to find eligibility and coverage information on the Eligibility screen of the Web portal.
• Eligibility verification tutorials (PowerPoint) or (PDF)

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Client benefit and HSC List information NEW

The Client inquiry can tell you whether a specific procedure is covered, requires copayment or requires prior authorization (PA) under the client's benefit plan. The HSC List inquiry can tell you whether a procedure is potentially covered according to the Prioritized List of Health Services.

• Client and HSC List Inquiry Guide (PDF): How to submit client inquiry, HSC List inquiry and combination client/HSC List inquiry.
• One-page quick reference (PDF): How to submit a combination inquiry and how to read the responses. 
• Also view the Web HSC List tutorial (PowerPoint or PDF)

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Prior authorization

• Web PA Handbook (PDF): How to search for and submit PA requests on the Web.
• Also view the Web PA tutorial (Powerpoint) or (PDF)

Billing and adjustments

• Professional Web Billing Instructions (PDF): Includes how to bill crossover claims on the Web. View the tutorial (Powerpoint) or (PDF)
• Institutional Web Billing Instructions (PDF): Includes how to bill crossover claims on the Web. View the tutorial (PowerPoint) or (PDF) NEW 
• Pharmacy Web Billing Instructions (PDF): Includes how to use the Drug Search function.
• Dental Web Billing Instructions (PDF): Also view the tutorial (PowerPoint and PDF) NEW 
• Plan of Care Roster Billing Instructions (PDF): Billing and Plan of Care information for Addictions and Mental Health (AMH) providers. Also view the roster billing quick reference (PDF)
• Web Adjustment Instructions (PDF): How to search for and adjust claims on the Web. For all claim types. Also view the Claim Search tutorial (Powerpoint) or (PDF)

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When you need help

At this time, personal identification numbers (PINs) for setting up Provider Web Portal accounts can only be mailed to a provider's physical address, not the mailing address.

• Requesting a new PIN: If you have lost your PIN for the Provider Web Portal and you need to request a new one, e-mail your provider name and provider (Medicaid) number to Team.Provider-ACCESS@state.or.us or call Provider Services. Due to privacy regulations, original PINs must be reissued through the mail. You will receive a new PIN in three to four days.
• Resetting passwords: Once your Provider Web Portal account has been set up, Provider Services can reset your password over the phone during regular business hours. Call 800-336-6016. Press 5 for resets.
• Troubleshooting the Provider Web Portal (PDF): If you are having problems accessing the Web portal or loggin in, refer to this document.

Training

Need training on how to use the Provider Web Portal? Try these resources:

• Walk through the Web portal functions using the MMIS provider eCourse on the DHS Learning Center (search for course C00818).
• DMAP has scheduled additional trainings for 2009. Search for courses C01033 and C01034 on the DHS Learning Center. Find out more on the MMIS Course Information page.

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