News from CareOregon's Provider Services Team
By Karry Donnelly, Provider Relations Supervisor, CareOregon
Have you visited the CareOregon website lately? If not, I would like to encourage you to visit the“What’s New” provider section. This area will keep you apprised of ongoing policy and procedural changes as well as provide you with resources to simplify administrative work in your practices. Take a look today.
On the contracting front, we would like you to know we have a new agreement in place with the Rite Aid Take Care Nurse Practitioners. This will give PCP’s one more resource available outside of emergency room and urgent care facilities. Please keep this option in mind as you triage members and recognize a need to refer them outside of your clinic for services.
Are you receiving information from CMS regarding NPI? We have learned of some new educational products which were just released by CMS regarding the National Provider Identifier. As we are all aware the deadline to apply for a NPI is fast approaching, to access these new products, as well as existing information please visit www.cms.hhs.gov/NationalProvIdentStand.
Here are a few tips recommended by your Provider Relations Representatives:
- Our new claims payment system, QNXT is not able to accept hand-written claims. Please make sure all claims are submitted in a typed format on a standard HCFA 1500 or UB92 appropriate form.
- You only need to bill us once for our members who have dual coverage thru CareOregon Advantage and CareOregon Medicaid, QNXT will auto create a secondary claim for processing purposes on the Medicaid side. You will continue to receive two vouchers and two payments. One for our Medicare Product, CareOregon Advantage and one for the Medicaid benefits.
- If you need assistance with claims or payments, please call our main number at 503-416-4100, select option 3 for provider, then option 3 again to reach a claims specialist. No need to contact your Provider Relations Representative for claims issues as we will need to redirect your call.
As always, we truly appreciate your commitment to serving the Oregon Health Plan and Medicare populations. We are here to help, please feel free to contact your provider relations representatives for training and or educational needs in your clinics and facilities. We would be glad to schedule an appointment with your staff at your convenience.
