Moving from paper to electronic claims may be easier than you think.
With electronic claims, you get real-time feedback about missing information or claim errors, so you can submit clean claims every time. It's also easy to get started.
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 OHA 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 Health Plan 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
Subscribe to OHP Provider Announcements to get text or email updates whenever OHA posts a new provider announcement. Provider announcements provide updates about OHP operational changes and rule revisions that affect how you do business with OHA.
Subscribe to OHP provider guidelines to get text or email updates whenever OHA updates Oregon Administrative Rules and supplemental information specific to your provider type.