Oregon Health Plan (OHP) Eligibility Verification

Verify Patient Eligibility, Enrollment and Service Coverage

Provider Services no longer provides eligibility or enrollment status over the phone. Please use the resources on this page for these inquiries. This maintains the privacy and security of protected health information.

Oregon Administrative Rule (OAR) 410-120-1140 requires providers to verify the patient's eligibility and benefit package. Providers must also verify the member's coordinated care organization (CCO) enrollment, whether services are covered by the Prioritized List of Health Services, and whether services require prior authorization. View the Keys to Success to learn more.

Oregon Health Authority (OHA) offers three ways to verify this information for OHP members:

MMIS Provider Portal >>

Eligibility and Enrollment Guide >>

Prioritized List of Health Services >>

Tools and Resources

To learn more about verifying eligibility and enrollment for Health Share of Oregon members, visit the Health Share of Oregon website.