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Health-Related Social Needs (HRSN) Provider Resources

Oregon Administrative Rules

Announcements

View updates for HRSN providers on the OHP 1115 Medicaid Waiver Updates page.

Provider Enrollment

HRSN service providers are organizations that:

  • Provide HRSN services. These include housingnutrition, and outreach and engagement benefits. HRSN service providers can choose to provide one, two or all of these benefits to Oregon Health Plan OHP members who quality.
  • Serve OHP members in a way that is culturally and linguistically appropriate, responsive and trauma-informed.​

To become an HRSN provider, your organization must identify which members you want to serve.

  • Most OHP members are in coordinated care organizations (CCOs). Providers need to contact their local CCO to find out how to join their network and serve CCO members.
  • About 10 percent of OHP members are not enrolled in a CCO. These members are known as "open card" members. Providers bill Oregon Health Authority (OHA) for services provided to these members.
    • OHA encourages providers to enroll with OHA to serve open card members. If providers do this first, it will reduce paperwork when enrolling with CCOs later.​

General Resources

CCOs and other community partners use Community Information Exchange (CIE)to support referrals for HRSN services. Learn more:​​

​View the journey:

The member journey is an interactive training tool for providers (not members). It is meant to help providers prepare to support members seeking HRSN benefits. The journey covers:

  • What are HRSN benefits?
  • What is the Oregon Health Plan?
  • Who can help?
  • Get started
  • Complete screening
  • Get decision
  • Get and use benefits
  • ​Helpful links​​​​

View the fact sheet:

​This fact sheet covers:

  • ​How to become an HRSN provider
  • What are HRSN services?
  • Who can become an HRSN service provider?
  • How to sign up to be an HRSN service provider

​View the journey:

The provider journey is an interactive document that covers:

  • What are HRSN benefits?
  • Who is involved?
  • Working with OHP members
  • Become an HRSN service provider
  • Enroll as an HRSN service provider
  • Provide HRSN benefits
  • Billing the CCO or OHA
  • Staying enrolled or disenrolling
  • Helpful links

To qualify, a member's yearly income mst be 30 percent or less than the area median income (AMI) where they live. This is just one part of HRSN eligibility; each HRSN benefit has different requriements to qualify.

Use this document to see if a member's income qualifies:

Visit the HRSN Provider Training page to join monthly trainings and learning collaboratives for HRSN providers and organizations interested in providing these services.​​

View the guide:

This guide covers:

  • What are HRSN services?
  • Who can get these services?
  • Who qualifies for HRSN services?
  • What is an HRSN service provider?
  • How to enroll as an HRSN service provider
  • How to provide HRSN services
  • Resources

HRSN Housing Benefits 

​Both HRSN O&E and HRSN Tenancy Supports activities are commonly described as case management, and many activities overlap. Learn more about when to bill for services as O&E or as Tenancy Supports.​

The OHP HRSN housing benefits page includes:

  • Member fact sheets
  • CCO and Open Card request forms and contact information​​​

HRSN Nutrition Benefits 

​Health care providers: Use this guide to ensure that HRSN medically tailored meals are medically necessary and appropriate for members who may qualify.

View the guide​

The ​HRSN nutrition ben​efits web page​ includes:

  • ​Member fact sheets
  • Eligibility guidelines
  • Request forms

HRSN Outreach and Engagement

​Both HRSN O&E and HRSN Tenancy Supports activities are commonly described as case management, and many activities overlap. Learn more about when to bill for services as O&E or as Tenancy Supports.​

​View the fact sheet:

The fact sheet covers:

  • ​​What are HRSN benefits?
  • What are HRSN outreach and engagement benefits?
  • Who provides HRSN benefits?
  • Payment for HRSN outreach and engagement benefits
  • Eligible activities
  • Who qualiies for HRSN outreach and engagement benefits
 
 

Billing for HRSN Services

See the HRSN fee schedule for covered codes, expected costs and payment rates: