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Oregon Health Plan (OHP) Member Complaints and Appeals

OHP Member Complaints

For complaints about OHP services or providers:

  • For services covered by coordinated care organizations (CCOs), contact the CCO.
  • For other services, contact OHP Client Services (800-273-0557).

Visit the Public Health website to learn how to file a complaint about:

  • An Emergency Medical Services provider, 
  • Trauma Systems provider, or 
  • Health care facility.

OHP Member Appeals

If OHP decides not to cover a health care service, members have options. They can appeal the decision with their CCO or dental plan. After the appeal they can also ask OHA for a hearing.

  • See the OHP Rules (410-141-3875 through 3915) for more about appeals.
  • See the OHP General Rules (410-120-1860) for more about hearings.

Frequently Asked Questions