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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.

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.



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 405TOHP 0405T - Medical Transportation OrderEnglish
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Recent provider updates

To view all recent OHP announcements, visit our Announcements page.

  
  
Applies To
  
5/17/2019GEMT Supplemental Payment Program Status - May 17, 2019Ground emergency medical transportation
5/16/2019UPDATE - Billing and authorization for rehabilitation services effective July 1 2019.pdfAMH-licensed residential treatment providers, Community Mental Health Programs, Mental health rehabilitation providers
5/13/2019Fee-for-service reprocessing of DRG outpatient claims planned for May 24 2019.pdfOregon DRG hospitals
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Questions and answers for OHP providers

You can use the Search field to filter the questions for your search term.



Need help?

For help with
Contact information
Nurse advice, and information about available providers, for members not in an OHP medical plan
OHP Care Coordination - 800-562-4620
Mailing addresses
Becoming an OHP provider or updating your information
Provider Enrollment – 800-336-6016 (option 6); also visit our Provider Enrollment page​
Complex billing questions, appeals and requests for claim reconsideration
Provider Services – 800-336-6016 (option 5, then 2)
Determining OHP coverage for specific condition / treatment pairs
OHP Code Pairing and Prioritized List Hotline - 800-336-6016 (option 4) or 503-945-5939
Fee-for-service medical and dental prior authorization requests
PA Line - 800-336-6016 (option 3) or 503-945-6821
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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