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Tools for Oregon Health Plan providers

Health care providers: Apply for new round of federal Provider Relief Fund payments by November 6, 2020

Starting October 5, 2020, providers can apply for new Provider Relief Fund payments. The federal Department of Health and Human Services (HHS) expects to distribute approximately $20 billion to eligible providers, including previous applicants and recipients, behavioral health providers and providers who began practicing in the first quarter of 2020.

Learn more on the HHS website.

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.

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:

  
  
10/9/2020
  
Diabetes Control & Dental Care for Patients with Diabetes; Apply for new round of federal Provider Relief Fund payments by November 6, 2020; Replacing health care items in event of natural disasters; Medicaid EHR Incentive Program Year 2020 will open on Sunday, November 1, 2020; Version 38 DRG implementation delayed; OHP 3047 Augmentative Communication Device Support Summary; Recent rule revisions

Read recent OHP announcements. To view older announcements, visit our Announcements page:

  
  
Applies To
  
10/20/2020Replacement of speech/hearing devices and supplies in event of natural disastersSpeech-Language Pathology, Audiology and Hearing Aid Service Providers
10/14/2020OHP coverage of COVID-19 testingAll Providers, CCOs
10/7/2020Transition of Personal Care Attendant service authorizations to Comagine HealthBehavioral health providers, Community Mental Health Programs, Behavioral health case managers
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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.
OHA 6625OHA 6625 - Order Form for ApplicationsEnglish
OHP 2410OHP 2410 - Newborn NotificationEnglish
OHP 1074OHP 1074 - Prior Authorization for Out-of-State ServicesEnglish
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Questions and answers for OHP providers

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



Need help?

Registration, technical assistance for electronic data interchange (EDI) trading partners
Becoming an OHP provider or updating your information
Provider Enrollment – 800-336-6016 (option 6); also visit our Provider Enrollment page​
Fee-for-service medical and dental prior authorization requests
PA Line - 800-336-6016 (option 3) or 503-945-6821
Nurse advice, and information about available providers, for members not in an OHP medical plan
OHP Care Coordination - 800-562-4620
Mailing addresses
Determining OHP coverage for specific condition / treatment pairs
OHP Code Pairing and Prioritized List Hotline - 800-336-6016 (option 4) or 503-945-5939
Complex billing questions, appeals and requests for claim reconsideration
Provider Services – 800-336-6016 (option 5, then 2)
Fee-for-service pharmacy prior authorization requests
Oregon Pharmacy Call Center - 888-202-2126
Direct deposit​
DHS|OHA Electronic Funds Transfer (EFT) Coordinator - 503-945-6872
Report client or provider fraud over the phone or online.​
DHS Fraud Hotline: 888-FRAUD01 (888-372-8301)
​Report third-party liability (TPL) to DHS/OHA
​Provider Web Portal password resets
​See our troubleshooting tips and other Provider Web Portal resources. If you still need help, contact Provider Services - 800-336-6016 (option 5, then 1)

​Behavioral health prior authorization requests

​KEPRO
Phone: 844-658-1729
Fax: 844-673-8034
Email: OR1915i@kepro.com

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