As we work together to stop the spread of COVID-19 at home, work and in the community, we want to make sure you have the resources you need to keep informed, healthy and safe. If you have any questions about OHP and COVID-19, please let us know.
Updates for Oregon Health Plan providers
Upcoming Community Partner webinar: Learn about billing COVID-19-related services for CAWEM members and interpreter services for fee-for-service OHP members.
Current non-emergent medical transportation (NEMT) requirements for expired licenses and vehicle registrations during COVID-19: According to current guidance from the Oregon Department of Motor Vehicles (DMV), coordinated care organizations (CCOs), brokerages, and NEMT providers may allow drivers with expired Oregon driver licenses or vehicle registrations to serve eligible Oregon Health Plan (OHP) members if:
- Their license or registration expired between Nov. 1, 2020, and April 30, 2021; and
- The license or registration has been expired for three months or less.
A three-month grace period will apply for these drivers while they wait for their appointment with DMV. To learn more about how this guidance applies to NEMT requirements, please read the Jan. 15 memo from the Oregon Health Authority (OHA).
OHP coverage of NEMT to alternate sites for COVID-19 vaccine administration: Oregon's 1135 waiver allows provision of Medicaid-covered services at alternate sites during the COVID-19 public health emergency. This includes rides to alternate sites set up for COVID-19 vaccine administration.
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to OHP coverage of testing, screening, treatment and telemedicine services; OHP eligibility; and other information and resources related to providing and billing for covered services during COVID-19.
- The guide now contains updated billing guidance for COVID-19 vaccine administration and incorporates the above guidance related to NEMT services.
Updates for all health care providers
Updated:
New:
Oregon veterans face a higher suicide rate than their civilian peers. For every military member who dies in combat, 25 to 30 more take their own lives.
Veterans face unique barriers to accessing medical and behavioral health care. Many providers, although highly skilled, are unfamiliar with military culture and the unique needs of veterans as they pertain to behavioral health, and more specifically, to suicidality.
To bridge this gap between providers and veterans seeking care, OHA encourages medical and behavioral health care providers to attend a free, two-day virtual training about veteran and military needs around mental health and suicide. There are two types of training:
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8 regional trainings where providers can share local resources and challenges
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3 statewide trainings focusing on underserved populations, including veterans and military servicemembers who are LGBTQ+, women, and/or Tribal members
Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of OHSU School of Medicine and Lines for Life. The OHSU School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit: Oregon Health & Science University School of Medicine designates this live activity for a maximum of 12 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
OregONEligibility (ONE) system upgrade nears completion
Starting Feb. 1, 2021, people in all Oregon counties will be able to apply for OHP and other medical, cash, childcare, and food benefits using the ONE system.
They can apply online and get help over the phone or in person at a local Aging and People with Disabilities, Area Agencies on Aging or Self-Sufficiency Programs office.
Dental program updates effective Jan. 1, 2021
OHA has added new CDT codes for fee-for-service billing, and is now ready to accept 2019 ADA claim forms for processing.
- The additions include 28 new CDT codes and opening three dental case management codes for fee-for-service payment. To view these codes as well as other 2021 coding updates and reminders, please review OHA's fact sheet.
- To review how to bill paper claims to OHA, please see OHA's Dental Billing Instructions. This handbook has been updated to include the 2019 claim form and how to bill for teledentistry services.
Providers will have one year to transition to the current ADA claim form or submit claims electronically. After that, OHA will return claims submitted on the ADA 2012 form beginning Jan. 1, 2022.
How to verify OHP eligibility and enrollment without the Oregon Health ID card
While OHA encourages providers to use the information on the Oregon Health ID card to correctly enter a patient’s information in the Provider Web Portal at https://www.or-medicaid.gov, patients are not required to present this card in order to receive care.
If a patient or their representative is unable to present the card at the health care visit, or does not know their 8-digit Oregon Medicaid ID number, you can still verify OHP eligibility and enrollment using the following combinations:
- Last name, first name and date of birth
- Social security number (SSN) and date of birth
- SSN, last name and first name
- SSN, last name and date of birth
- SSN, last name, first name and date of birth
To learn more about eligibility verification options, resources and requirements, please visit the OHP Eligibility Verification page.
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