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Oregon Health Plan (OHP) Fee-for-Service Claim Status

How to Check Claim Status 

Oregon Health Authority (OHA) offers these ways to check the status of claims you submit to OHA:

The Provider Portal at https://www.or-medicaid.gov allows you to view PDF versions of the paper remittance advice. You can also review and adjust, void or resubmit claims as necessary. For more information, view the Claim Adjust​ment Handbook and the step-by-step instructions. 

Accessing the portal

To use the portal, you will need:

  • The PIN letter issued by Oregon Health Authority when you enrolled as an Oregon Health Plan provider; or
  • Permission from the person in your organization that manages access to the portal.

To learn more, visit the Provider Portal Resources page.

Searching for claims 

View the step-by-step instructions or see page 5 of the Claim Adjustment Handbook.​

​All enrolled providers will get a paper remittance advice by mail. It summarizes the claim activity submitted for the prior week.

Providers can choose to stop getting the remittance advice by mail and get it online. To do this, use the "Online RA" role in the MMIS Provider Portal and click the "Stop Paper RA" button. Once you do this, you will stop getting the paper RA and start getting a PDF of the paper RA online.

If you do not have Provider Portal access, you can also contact Provider Enrollment (800-336-6016) and ask to stop receiving the paper RA. Please provide the Provider ID listed in the "Payee ID" or "NPI ID" field in the top right corner of the paper RA. ​

This free touchtone service from OHA ​will read you information about the first six claims for the ICN or client ID you request claim status on. 

After that, you need to use the Oregon Medicaid Provider Portal for additional information. For more information, refer to the AVR Quick Reference.​

Electronic data interchange (EDI) trading partners can get claim status through the 835 transaction. You can get this transaction from OHA or through your clearinghouse. To do this:

  • ​Log into the Provider Portal, then go to Providers>835 Signup. ​
  • ​Complete all required fields (marked with an asterisk). This information must match your Oregon Medicaid provider enrollment record and Trading Partner Agreement with OHA. 
  • See the 835 Signup Instructions to learn more.
You must also complete a new Trading Partner Agreement if:
  • You use a clearinghouse and have not previously signed up for the 835 transaction.
  • Any of information entered on the 835 Signup (e.g, TIN, business name, address, NPI or Oregon Medicaid ID) does not match what is on your current Trading Partner Agreement with OHA.

To learn how to become an EDI trading partner, visit the EDI page​.

Resources

Also refer to the HIPAA-compliant Claim Adjustment Reason Codes and Remittance Advice Remark Codes. AVR and EDI use these codes to describe the status of a claim.