Physical health providers



Provider Manual

The CareOregon Provider Manual can be used by CareOregon/Oregon Health Plan and CareOregon Advantage/Medicare contracted providers. The manual has information on the following topics:

  • Membership
  • Benefits
  • Referrals and authorizations
  • Billing and payment
  • Interpretation
  • Transportation for OHP members
  • Provider Relations Specialists
  • Primary care
  • Medical records
  • Quality improvement
  • Credentialing
  • Medicare Advantage
  • Clinical practice guidelines

If you have questions, please contact your provider relations specialist .

This section includes CareOregon’s medical policies, forms and medical management guidelines.

Forms change and are updated here on a regular basis, so please be sure to return to this page for the most up-to-date forms and policies.

 

Eligibility

Use the provider portal to verify a member’s eligibility with CareOregon.

 

Authorization guidelines

Changes are posted on the 15th day of the calendar month (or the next business day).

 

CPT code grid: Diagnostic and treatment procedures

 

DME: Authorization and code lists

 

Frequently asked questions (FAQs)

Authorization request forms

 

Medicare behavioral health policy and form

 

Miscellaneous policies and forms

2022 Metrics Medicaid Toolkit 

2021 Metrics Toolkit 

More resources