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

9/22/2023	Tell OHA what you think! Date announced for listening sessions about CareOregon
Winding down the COVID-19 Public Health Emergency webinars; Tell OHA what you think! Date announced for listening sessions about CareOregon; Join OHA's Café Connect Event series about social needs screening and referral; Starting Nov. 1, 2023, OHP covers flu vaccine administration for members under age 19 only when provided through the Vaccines for Children program; Non-participating provider reimbursement for child/adolescent psychiatric units, effective July 1, 2023; Fee-for-service rate increases for dental services effective Oct. 1, 2023; Provider resource updates; Recent rule revisions (telehealth and ground emergency medical transportation)

Read recent OHP announcements

To view older announcements, visit our Announcements page:

Issue Date	Announcement (PDF)	Applies To
9/27/2023	No prior authorization needed for fee-for-service orthodontic evaluations, effective October 1, 2023	Dental providers
9/18/2023	Fee-for-service rate increases for dental services effective October 1, 2023	Dental providers
9/15/2023	NEMT coverage of travel to Women, Infants and Children (WIC) program service visits	Non-emergent medical transportation brokerages

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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.

English

MSC 0189 - Direct Deposit Authorization

English

MSC 1419

MSC 1419 - MAC Local Match Leveraging Form

English

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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

Sign Up for Updates

Get OHP Provider Updates by email.

Also sign up for OHP rule updates:

Notices of proposed rulemaking
Temporary rules

Important Links

Need Help?

For services to CCO members, call the member's CCO.

For services tp other OHP members, call Provider Services at 800-336-6016.

To find other contacts:

View the OHP provider contacts list
Use the searchable list at the bottom of this page