Tools for Oregon Health Plan providers

Search All Provider Tools

Use the Search field to find the tool you need. For example, enter "guide" to view all provider guides, "claim" or "billing" to view tools related to claims or billing, or "APC" to view all ambulatory payment classification (APC) tools.

• To view current rules, please visit the OHP policies page.
• To view the fee schedule, please visit the OHP fee schedule page.
• To find Medicaid Program Integrity resources, please visit the CMS website.

Need help? If you can't find what you need on this page or in the "Important Links," see our provider contacts list, and the list at the bottom of this page. If you need help with approval or payment for services to a CCO member, contact the CCO.

Recent Provider Updates

Read the latest Provider Matters

View past issues on the Provider Matters page.

Issue Date    Link    3/24/2023 Learn more about the OHP 1115 Medicaid Waiver for 2022-2027    Preparing for the COVID-19 Public Health Emergency to end - Join the monthly partner webinar series; Learn more about the OHP 1115 Medicaid Waiver for 2022-2027; Extension of temporary rate increase for Enhanced Care Services, effective April 1, 2023; Administrative Exam Fee Schedule effective Jan. 1, 2023; updated resources about Culturally and Linguistically Specific Services, Integrated Co-occurring Disorders, SUD 1115 waiver, and EPSDT

Compliance Details

javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+ '/_layouts/15/itemexpiration.aspx' +'?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/hold.aspx' +'?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/Reporting.aspx' +'?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/expirationconfig.aspx' +'?ID={ItemId}&List={ListId}'); return false;}}, null);

0x0

0x1

ContentType

0x01

898

Read recent OHP announcements

To view older announcements, visit our Announcements page:

Issue Date       Announcement (PDF)    Applies To    3/23/2023 Extension of temporary rate increase for Enhanced Care Services, effective April 1, 2023 Enhanced Care Services providers 3/16/2023 Fee-for-service birth center facility fee rate increase, effective July 1, 2022 Birthing centers 3/10/2023 Fee-for-service reprocessing for certain Home and Community-Based Services claims starting March 3, 2023 Behavioral health providers, Home health agencies, School-Based Health Services providers, Targeted Case Management providers, AMH-Licensed Adult Foster Homes

1 - 3

Compliance Details

javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+ '/_layouts/15/itemexpiration.aspx' +'?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/hold.aspx' +'?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/Reporting.aspx' +'?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/expirationconfig.aspx' +'?ID={ItemId}&List={ListId}'); return false;}}, null);

0x0

0x1

ContentType

0x01

898

Forms and Publications

View OHP Billing Tips or the provider guidelines for your program for more information about provider forms. Find forms for enrolling as an OHP provider on our Provider Enrollment page.

• Click the "Form and Description" heading to sort or select by Form. You can also sort or select by Language.
• To view all OHP forms and publications, visit our Forms page.

Form Number Form and Description Language Advance Directive Advance Directive English MSC 0189 MSC 0189 - Direct Deposit Authorization English MSC 1419 MSC 1419 - MAC Local Match Leveraging Form English

1 - 3

Compliance Details

javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+ '/_layouts/15/itemexpiration.aspx' +'?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/hold.aspx' +'?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/Reporting.aspx' +'?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ '/_layouts/15/expirationconfig.aspx' +'?ID={ItemId}&List={ListId}'); return false;}}, null);

0x0

0x1

ContentType

0x01

898

Questions and Answers for OHP providers

Use the Search field to filter the questions for your search term.

• If you have questions about how to authorize or bill for services to OHP health plan members, contact the member's OHP coordinated care organization or dental plan.
• If you have questions about services to members not in an OHP health plan, see our address and phone contacts.

Find OHP Provider Contacts by Topic