Moving from paper to electronic claims may be easier than you think.
If you have questions about billing on the Web, contact Provider Services (800-336-6016). If you have questions about electronic data interchange (EDI), contact EDI Support Services (888-690-9888).
Step 1: How will you submit your claims?
Once you decide to bill OHA electronically, you will need to select how you will submit your claims:
- Individually on the Provider Web Portal at https://www.or-medicaid.gov - Web claims can be copied and edited to make individual claim submissions even easier.
- In batches using electronic data interchange (EDI) - EDI claims can be submitted to DMAP through your own software, or by contracting with a clearinghouse or billing service that transmits the EDI claims for you.
Step 2: Contact OHA to get electronic access
Want to bill on the Web?
- Most Oregon Medicaid providers are authorized to use the secure Provider Web Portal at https://www.or-medicaid.gov.
- Your office should have a Web administrator who can delegate Claims Submit access to billing staff.
- If you aren't sure, contact Provider Services (800-336-6016) and they can help you figure out the next steps.
Want to bill using EDI?
- If you want a billing service or clearinghouse to submit EDI claims for you, you can also contact a service already registered with OHA.
- Once approved, you and/or your EDI submitter may need to submit test claims to make sure "live" claims process correctly in our system.
Step 3: Start billing (and getting paid) electronically!
As with paper claims, before submitting electronic claims, you must verify that the client was eligible on the date services were provided.
Step 4: Keep informed
eSubscribe to OHP Provider Announcements to get automatic e-mail notification whenever DMAP posts a new provider announcement. Provider announcements provide updates about OHP operational changes and rule revisions that affect how you do business with OHA.
eSubscribe to OHP provider guidelines to get automatic e-mail notifications whenever OHA updates Oregon Administrative Rules and supplemental information specific to your provider type.