OHSU Health Services for Providers and Clinics

Provider information and benefit tracker

Information about medical eligibility, benefits, claims and referral information.

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Information and resources

Metro Area Behavioral Health Access

To support OHSU Health IDS members transition from CareOregon providers, Health Share of Oregon is distributing a list of CareOregon behavioral health providers who have appointment access.  The list is refreshed approximately every two weeks.

If you can’t find a provider who is accepting new members, or have any questions, contact CareOregon customer service and choose Option 3 for Provider: 503-416-4100 or 800-224-4840.  You may refer high-risk and/or medically complex members for care coordination by submitting a referral to the CareOregon Regional Care Coordination Team to assist in transitioning their care to a new provider: https://www.careoregon.org/providers/support/care-coordination 

 

How to use the Auto Auth Application

Use the Auto Auth Application How-to Guide to navigate the new program. If you have a question not covered in the FAQ, call Medical Customer Service for further assistance at 844-827-6572.

Prior Authorization Guidelines

 

Provider resources

Forms

Birth doula services and traditional health workers

Doula care is a covered benefit for OHP members. The benefit package covers two visits before delivery, support during delivery, and two visits post-delivery. OHSU Health Service OHP members can use: 

OHSU Health IDS promotes the use and inclusion of licensed/certified traditional health workers, including peer support specialists, peer wellness specialists, personal health navigators and community health workers. OHP members do not need a referral to work with a traditional health worker. 

Ride to Care information

Pharmacy prior authorization and formulary

Prior authorization for provider-administered drugs

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Pre-payment claims edit to diagnosis criteria and criteria for maximum units. Prior authorizations do not apply for this policy.

UM Criteria

Evidence-based practice guidelines

The following clinical practice guidelines are intended to support our health care providers and serve as resources to ensure our providers have relevant, evidence-based information about our adopted standards of care.

OHSU Health IDS has adopted the following evidence-based practice guidelines:  

Additionally, as part of Health Share of Oregon, the following guidelines apply to our OHSU Health IDS provider network.

Health Share of Oregon Clinical Practice Guidelines

  • Find links and a downloadable PDF.

Health Related Social Needs (HRSN) Benefits

OHSU Health Service members experiencing specific life transitions may be eligible for free devices and housing support to help create a healthier living environment. 

Who is eligible for the HRSN benefits?
This HRSN benefit targets specific populations among OHP members experiencing life transitions. They must also have a qualifying medical need. Visit Oregon Health Authority’s website for details about qualifications. Not all OHP members will be eligible.

What does the HRSN Nutrition Services Benefit provide?

Eligible members who have a qualifying medical health need related to nutrition can get nutrition education and medically tailored meals. This benefit does not provide for general food insecurity at this time.

What does the HRSN Housing Benefit provide? 

  • Rental assistance, like rental payments, deposits, utility assistance for up to 6 months
  • Medically necessary home modifications, like ramps, handrails, environmental remediation
  • Tenancy support services, like eviction prevention, housing case management 

What does the HRSN Housing Benefit NOT offer?

  • Temporary or other housing for people who are currently houseless or experiencing homelessness
  • Emergency shelter needs
  • Mortgage support

What does the HRSN Home Changes for Health During Extreme Weather provide?

  • Air conditioners
  • Air filtration devices
  • Mini refrigeration units
  • Portable power supply
  • Portable/space heaters

To apply for HRSN nutrition or housing benefits:

To apply for HRSN Helping Members Stay Healthy at Home During Extreme Weather

More information:

Advance directives

Visit OHA's website for forms in multiple languages and an overview of advance directives.

Oregon State Agency Requested Medical Records:

Anytime an Oregon state agency is requesting medical records, they will provide one of two forms to providers. If the patient is an Oregon Health Plan member on the date of service, the agency will provide Form 729 which allows the provider to bill the Division of Medical Assistance Programs for the cost of medical record copying charges (and mailing if applicable).

In order to be paid by DMAP, the provider must complete an HCFCS 1500 and attach Form 729 for the claim to be processed by DMAP.

While the form offers a physical mailing address as a means to submit these forms, it is more efficient (and trackable) to submit using the EDI portal (the same portal used to process Open Card submissions).

Questions about the portal should be directed to DMAP Provider Relations at 800-336-6016.

If the patient is not an Oregon Health Plan eligible member on the date of service, the agency will provide Form 501A which allows the cost of the medical record copying charges (and mailing if applicable) to the Oregon General Fund (through the agency requesting the records).

Contact Provider Relations

Call 503-418-7750 or email ohsuhealthprvrelations@ohsu.edu.

 

Compliance guides and attestation forms

Submit attestations annually before Dec. 31 to ohsuhealthprvrelations@ohsu.edu or fax to 503-346-8041.

Cultural Competency

The Oregon Medical Board requires cultural competency training for all new medical licenses and for all renewing providers. Starting in October 2021, providers must demonstrate on initial and renewal application for credentialing that they meet the state requirements by submitting proof of completion of the training in cultural competency.

Many different types of courses and experiences meet the cultural competency continuing education requirement including experiential or service learning, cultural or linguistic immersion, volunteering in a rural clinic, courses approved by the Oregon Health Authority and more.

Cultural Competency training discount for OHSU Health IDS network providers through Oregon State University College of Pharmacy

OHSU Health IDS providers can receive a 25% discount for this Oregon Health Authority-approved training, regularly priced at $60 per student. Find details in this letter.

  • All Healthcare Providers - $15 off - use promo code OHSUCCALL15 (All-Providers)
  • OBMI/ARRT - $15 off - use promo code OHSUCCOBMI15 (OBMI/ARRT)
  • Pharmacist/Technician -  $15 off - use promo code OHSUCCACPE15 (ACPE)
  • CME  - $10 off -  use promo code OHSUCCCME10 (ACCME)

Below are some additional resources to help you locate cultural competency continuing education opportunities. For questions regarding the cultural competency requirements, email OHSUHealthPrvRelations@ohsu.edu.

 

Coding and documentation education resources

OHSU Health 2025 Coding Education Webinars

2025 dates: All meetings 8 - 9 a.m.

01/21/25 - ICD-10-CM Coding and Documentation for Chronic Diagnoses
02/18/25 - ICD-10-CM Documentation and Coding for for SDOH and other “Z” codes
03/18/25 - ICD-10-CM Documentation and Coding for Neoplasms
04/15/25 - ICD-10-CM Documentation and Coding for Pregnancy and Prenatal Conditions
05/27/25 - ICD-10-CM Updates and Hot Topics
06/17/25 - ICD-10-CM Documentation and Coding for Mental Health Diagnoses
07/15/25 - ICD-10-CM Documentation and Coding for Injections and Infusions
08/19/25 - ICD-10-CM Documentation and Coding for Brain-Related Conditions
09/16/25 - ICD-10-CM Updates and Hot Topics
10/21/25 - ICD-10-CM Documentation and Coding for Diabetes
11/18/25 - ICD-10-CM Documentation and Coding for Orthopaedic Conditions
12/16/25- ICD-10-CM Documentation and Coding for Vascular Diagnoses

Z codes

 

 

OHP and OHSU Health forms

Below are forms and links you may need.

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