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Medical & Dental Resources
Partnering for Community Health
Health Share works through multiple affiliated health plan partners to meet the medical and dental needs of its members in Clackamas, Washington, and Multnomah counties.
In order for medical and dental health providers to serve Health Share members, they must be contracted for the Medicaid line of business with one or more of our medical and dental health plans. Health Share does not directly contract with medical or dental health providers.
All questions, concerns, and problems regarding contracting, authorizations, billing, grievances and services related to medical or dental health need to be directed to the member’s specific medical or dental health plan. Health Share members may choose from one of four medical health plans and one of four dental health plans.
Providers can find the medical and dental health plans to which a member is assigned on the member’s Health Share ID card, or in the Health Share Provider Portal (CIM). If you do not have access to the Health Share Provider Portal, you can call the Health Share Customer Service at 503-416-8090 or toll free at 888-519-3845.
Health Plan Contacts
Medical Health Plan Contacts
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Provider Contracting
Phone: 800-224-4840
Email: newcontractrequest@careoregon.org
OnlineProvider Oregon Medicaid Enrollment
Enrollment Form (needs updated link)
Enrollment Info (needs updated link)
Provider Relations
503-416-4100 or 800-224-4840, Option 3 for Provider
Fax: 503-416-1478
Authorizations/Referrals
Claims Submissions
Electronic Claims: Providers should access their clearinghouse to identify the Payer ID for CareOregon claims.
Paper Claims: Paper claims should be mailed to:
CareOregon
P.O. Box 40328
Portland, OR 97240-0328You can call either 503-416-4100 or 800-224-4840 to reach CareOregon Provider Services for questions regarding claims submissions.
Please visit CareOregon’s Provider Support page for more information regarding claims submission.
Claims Inquiries
claimshelp@careoregon.org *
* All emails containing protected health information (PHI) must be sent in a secured manner.*Phone: 503-416-4100 or 800-224-4840, Option 3 for Provider
FWA Reporting
Provider Portal
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Provider Contracting
Phone: 503-813-3376Provider Oregon Medicaid Enrollment
Email: NW-Provider-Enrollment@kp.orgProvider Relations
Phone: 503-813-3376Claims Submissions
Electronic Claims: Providers should access their clearinghouse to identify the Payer Id for Kaiser claims.Paper Claims: Paper claims should be mailed to:
Kaiser Permanente National Claims Administration
P.O. Box 370050
Denver, CO 80237-9998Claims Inquiries
Phone: 866-441-1221 or 503-735-2727FWA Reporting
Phone: 888-774-9100 -
Provider Contracting
Email: PHPProviderContracting@providence.orgProvider Oregon Medicaid Enrollment
Phone: 503-574-7500 or 800-878-4445
Email: Map.enrollment@phtech.comAuthorizations/Referrals
(must sign into Provlink to view)Claims Submissions
Electronic Claims:
Providers should access their clearinghouse to identify the Payer ID for Providence and can visit the Providence EDI website for more information.Paper Claims:
Paper claims with dates of service 2020 and earlier should be mailed to:
Providence Health Plans
Att: Claims Processing
PO Box 3125
Portland, OR. 97208-3125Paper claims with dates of service 2021 and later should be mailed to:
Providence Health Assurance
PO Box 14590
Salem, OR 97309Claims Inquiries
Phone: 503-574-7500 or 800-878-4445FWA Reporting
Phone: Call Providence Health Plan's Special Investigations Unit at 503-574-8505 or toll free at 888-233-4101
Mail:
Special Investigations Unit
Providence Health Plans
P.O. Box 3150
Portland, Oregon 97208-3150
Online: Complete the External Referral Form (PDF). Print it and send it by
mail or secure fax to 503-574-8142Provider Manual
(must sign into Provlink to view) -
Provider Relations/Contracting
Phone: 833-861-2057
Fax: 503-261-6055
Email: OHSUHealthPrvRelations@ohsu.eduProvider Oregon Medicaid Enrollment
Phone: 503-418-7750
Fax: 503-346-8041
Email: OHSUHealthPrvRelations@ohsu.eduAuthorizations/Referrals
Phone: 844-931-1774
Fax: 833-949-1887Claims Submissions
Medical Claims
Paper Claims
Mailing Claim Address:
PO Box 40384
Portland, OR 97240Electronic Claims
Clearinghouses:Ability/MD Online
Availity
Change Healthcare
MCPS –Medical Claims Processing Solutions
Office Ally
Payer Connection
Relay Health
Payor ID: 13350 (Moda Health)
Phone: 844-827-6572
Pharmacy
Mailing Claim Address:
OHSU PBM Services
8300 SW Creekside Place, Suite 100
Beaverton, OR 97008
Phone: 844-827-6572Claims Inquiries
Phone: 844-827-6572FWA Reporting
Phone: 855-801-2991
Email: StopFraud@modahealth.comProvider Manual
Online: https://www.modahealth.com/medical/policies.shtmlProvider Portal
Online: www.modahealth.com/medical/mbt.shtml
Dental Health Plan Contacts
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Provider Contracting + Customer Service
Phone: 866-268-9631 -
Provider Contracting + Customer Service
Phone: 503-416-1444 or 888-440-9912 -
Provider Contracting + Customer Service
Phone: 503-813-2000 or 800-813-2000 -
Provider Contracting + Customer Service
Phone: 503-243-2987 or 800-342-0526 -
Provider Contracting + Customer Service
Phone: 855-433-6825
Plan Change Requests
If you are a Medical or Dental Health Provider, or an OHP Assister, and would like to submit a plan change request on behalf of a Health Share Member, please complete the Medical Health Plan Change Request Form (PDF) or Dental Health Plan Change Request Form (PDF).
Please note: Providers may only request that a member be moved to a medical or dental health plan that the provider is currently contracted with.