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 Behavioral Health or Substance Use Disorder (SUD) provider, you may request to be considered for a contract 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.
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 Pathway's 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:
- Work in East Multnomah County and/or rural areas of Clackamas and Washington Counties and;
- 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:
- Established relationships with prescribers to meet urgent and ongoing medication needs and;
- Ability to provide appointment within 7 days of a hospital discharge and;
- Ability to provide crisis and after-hours access
How to Contract with Us
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:
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.
Complete the following Health Share Provider Interest Form that corresponds to your Provider type:
Submit Your Information
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.
Next Steps & Other Information
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. Please refer all Health Share members seeking behavioral health or substance abuse care to our Customer Service Center at (503) 416-8090 so that they can be connected with a contracted provider who can provide them timely care.
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
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 Assistant