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Oregon Health Plan Provider Web Portal - Questions and answers

Learn more about the Provider Web Portal. For more information and resources, go the Provider Web Portal information page.

 

 OHP-Faqs

 
  
Answer
Can you tell me where the PIN letter for my office will be mailed to? 

The PIN letters will go to the mailing address on file for each provider. If you have multiple locations or providers to bill for and want to know which location your PIN letters will go to, contact DMAP Provider Enrollment (800-422-5047).

What happens if I lose or misplace my PIN letters? 

You will need to contact DMAP Provider Services (800-336-6016) with your DMAP provider number so that they can send a new PIN letter to you by U.S. mail. It will take 3-5 business days to arrive.

What are the system requirements for the Provider Web Portal?
You will need a compatible browser and an internet connection. If you have support staff who do not have internet access and you want them to perform certain functions of the Web portal, make sure you get them appropriate access.
  • Microsoft Internet Explorer 6
  • Microsoft Internet Explorer 7 Service Pack 2
  • Microsoft Internet Explorer 8 and 9 in Compatibility View
  • Mozilla FireFox 2.0
Can I look up Primary Care Provider (PCP) information? 

No. To obtain information about the member's PCP, you would continue to contact the member's OHP managed care plan.

What is the best way to handle password resets for a large number of clerks? Are there any other options than requesting resets by phone?

To avoid password resets, you need to make sure that employees know to not do more than two (2) failed logins attempts.

After the second failed login, don't try a third time. Instead, go straight to the reset password screen of the Web portal and reset your password by answering one of your secret questions.

Can I use the Provider Web Portal on a Mac instead of a PC? 

The Provider Web Portal supports Mozilla Firefox 2 on PCs, but at this time, we do not know whether the Provider Web Portal supports Mozilla Firefox 2 on Macs. Ensuring Web portal support of Macs is planned as a future enhancement.

How often do Provider Web Portal passwords expire? 

They expire every 90 days.

If the Web portal maintains six years of claims data, do I still need to keep my own claims on file for auditing purposes? 

The availability of historical claims data on the Web portal does not replace your office's recordkeeping requirements, or any existing state and federal rules for keeping necessary claims documentation on file.

We are a facility with individual practitioners working for us. Will our practitioners have access? 
Your individual providers may get PIN letters if they have their own state Medicaid ID. This will be in addition to the PIN letter your group/clinic gets.
  • If your individual providers have separate Web portal access, anything they submit will be tied to their Medicaid ID number, not the facility's.
If everything done at your company needs to be tied to the group/clinic's ID, you may decide not to set up Web portal accounts for your individual providers. You might opt to set up your primary account, and all clerk accounts, underneath the clinic/group's ID using the corresponding PIN letter.
  • Then, when you submit something such as a claim or PA that must be tied to a specific provider, you can enter the provider's NPI in the rendering/servicing provider ID field on the Web portal.
When using the "search" links to locate codes and other values, will the results start with the search criteria I entered or will results contain the search criteria I entered?

The search links return results that start with the search criteria you entered. For example, searching for the word "viral" will return all results that start with the word "viral." It will not return all possible results containing the word "viral."

Is the Web portal secure?

Yes, it is secure. The Provider Web Portal is available only to enrolled providers authorized to use the portal. Users must have a secure username and password to access the portal.

How will providers get access to the Provider Web Portal?

DMAP will send authorized providers an initial logon ID and PIN via U.S. ground mail. Providers will then need to login and select a unique username and password in order to start using the Provider Web Portal.

How far back will providers be able to access historical claims? 

All claims on file in the MMIS will be available to providers. Initially, this will include six years of converted historical claims (plus all lifetime procedure claims), and will eventually grow to include 10 years of historical claims.

We are a billing agency that bills for many providers. Can we get one Web Portal ID set up for us to access all of our providers' information?
No. You will need to contact each of your customers and ask them to give you access to their Web portal accounts.
 
One of your customers will have to create a Web portal account for you so that you are in the Web portal system. Once that account is created, you can communicate the information for your account to your other customers so that they can search for you and add you as a clerk on their own Web portal accounts.
What if the Third-Party Liability (TPL) panel does not show the same health coverage information than what we have for an OHP member?

Report the resource to the DHS | OHA Office of Payment Accuracy and Recovery using the MSC 415H (Notification of Other Health Insurance).

Does the Medicare Paid Amount field allow negative dollar amounts? 

No. The paid amount must be greater than or equal to zero.

Can we search for more than a one-month eligibility time span? 

The Web portal allows you to view up to 13 months of historical eligibility data (through the date of inquiry). You can't request eligibility verification for future dates.