Tools for Oregon Health Plan providers

New: Young Adults with Special Health Care Needs Benefits

Learn about this new eligibility category that starts Jan. 1, 2025. Find more resources on the Young Adults with Special Health Care Needs (YSHCN) page:

• Provider guidance
  
• Provider announcement (12/19/2024)
• Fact sheet 
  

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.

Read recent OHP announcements

To view older announcements, visit our Announcements page.

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    200-814523 Request to Bypass Timely Filing English Advance Directive Advance Directive English FFS TPA OHA Trading Partner Agreement - Fee-for-Service English

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Compliance Details

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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