Contracting with Health Share

Health Share of Oregon works with multiple affiliated health plans and their Provider networks to meet the medical, dental, mental health and substance use disorder treatment needs of our Members in Clackamas, Multnomah and Washington counties.

If you are a Mental Health or Substance Use Disorder (SUD) Provider, you may request to be considered for a contract directly with Health Share.

If you are a Physical or Dental Health Provider, you may request to be considered for a contract with one or more of our four Physical Health Plans or nine Dental Health Plans. Health Share does not contract directly with Physical or Dental Health Providers.

If you are an Integrated Physical and Behavioral Health Provider, please review our Specialty Behavior Health and Integrated Services Overview document to determine if the services you offer are considered Physical Health or Behavioral Health prior to requesting a contract. 

If you are a Provider who is not located in or near Clackamas, Washington, or Multnomah counties, and has provided Behavioral Health services to a Health Share Member, please call 971-334-8056 for additional information.  If you are a Provider who is not located in or near Clackamas, Washington, or Multnomah counties, and has provided Physical Health services to a Health Share Member, please call the member’s Physical Health Plan.  If you do not know who the Member’s Physical Health plan is, please call 503-416-8090 or 888-519-3845 to determine the member’s Physical Health Plan

Provider Update | FamilyCare Closure

Behavioral Health Providers

Health Share Pathways

In order to better integrate and coordinate the array of mental health and addiction services for our members, Health Share established a regional behavioral health system of care called Health Share Pathways. Through Health Share Pathways, Health Share contracts directly with providers to deliver both mental health and substance use disorder treatment services.

All contracted Health Share Providers are required to follow federal and state laws and regulations related to providing services to OHP beneficiaries.  The purpose of those laws and regulations is to ensure Member safety and provision of quality care and include requirements related to credentialing, criminal records checks, fraud, waste, and abuse, privacy, Member rights, abuse reporting, grievance and appeals, record keeping standards, and other applicable criteria. 


While the Health Share Pathways' network is comprehensive, we are currently interested in behavioral health and substance use disorder providers who:

·        Specialize in Applied Behavioral Analysis (ABA) treatment services

·        Offer psychiatric medication prescription and monitoring services

·        Outpatient providers who:

o   Work in East Multnomah County and/or rural areas of Clackamas and Washington Counties and;

o   Offer a comprehensive service array and have the ability to work with members with varying levels of acuity. 

 

Outpatient providers that meet the above must also have:

o   Established relationships with prescribers to meet urgent and ongoing medication needs and;

o   Ability to provide appointment within 7 days of a hospital discharge and;

o   Ability to provide crisis and after-hours access

If you are a behavioral health or substance use disorder provider, meet any of the above criteria, and are interested in being considered for the Health Share Pathways Provider Network, please: 

1.    Review the Health Share Provider Manual to ensure your services comply with statutory and practice requirements required by Health Share. You may also review our Behavioral Health Fee Schedules for additional information regarding reimbursement.

2.    Complete the following Health Share Provider Interest Form that corresponds to your Provider type: 

·        If you are applying as an organization, please use the Organizational Provider Information Form

§ Organizational Provider Information Form (Fillable PDF)

§ Organizational Provider Information Form (Fillable Word document)

 

·        If you are a solo practitioner, please use the Solo Practitioner Provider Information Form

§ Solo Practitioner Provider Information Form (Fillable PDF)

§ Solo Practitioner Provider Information Form (Fillable Word document)

 

You may submit the completed form and W9 via email to Providers@healthshareoregon.org or via FAX to 503-459-5749, Attn: Contracts and Network Management.

 

Health Share will review provider interest forms on a regular basis.  Providers will be contacted only if additional information is needed.

 

Please be aware that completing a Provider Information Form does not guarantee network participation

 

If you have treated Health Share members but have not obtained a prior authorization, services may not be reimbursed, and per OAR 410-120-1280, the member may not be billed.

 

As you are not currently contracted with Health Share, all Health Share members currently seeking care should be referred to our online provider directory to find a provider within the Health Share network who can offer them timely care. If they want assistance finding a provider who meets their needs, they can call the member services number associated with their county of residence:

Clackamas County: 503-742-5335

Multnomah County: 503-988-5887

Washington County: 503-291-1155

Physical & Dental Health Providers

Health Share does not directly contract with physical or dental health providers. In order to provide services to Health Share Members, all physical and dental health providers must be contracted as an OHP (Medicaid) provider with one or more of the physical or dental health plans listed below.

 

Providers who deliver physical and dental health services should contact each plan individually to inquire about the plan's contracting requirements and process.

 

 Physical Health Plans

§  CareOregon: newcontractrequest@careoregon.org; 800-224-4840; or visit http://www.careoregon.org/Providers/ProviderSupport.aspx

§  Kaiser: 503-813-3376

§  Providence: PHPProviderContracting@providence.org

§  Tuality:  Erin Blume: Erin.Blume@tuality.org  |  503-681-1688

 

Dental Health Plans

§  Access Dental Plan: 503-445-9056 or 877-213-0357

§  Advantage Dental Services: 866-268-9631

§  Capitol Dental Care: 503-585-5205 or 800-525-6800

§  CareOregon Dental:  503-416-1444 or 888-440-9912

§  Family Dental Care: 503-584-4245 or 866-875-1199

§  Kaiser Permanente Dental: 503-813-2000 or 800-813-2000

§  Managed Dental Care of Oregon: 503-581-1407 or 800-538-9604

§  ODS Community Health Dental Plan: 503-243-2987 or 800-342-0526

§  Willamette Dental Group: 503-952-2000 or 855-433-6825

 

 

If you have additional questions please contact:

Health Share Contracting and Provider Network
Email:
providers@healthshareoregon.org