Health Share of Oregon uses our web portal for providers to verify member eligibility. Clinical Integration Manager (CIM) is available for all Health Share providers.
Providers and health plan staff have previously relied on MMIS eligibility to verify a member’s eligibility and to which Health Share plan partner they are assigned. The Health Share web portal (CIM) supplements MMIS by allowing provider office staff to verify what plan partner a Health Share member is assigned.
Below you will find the answers for many frequently asked questions. If you see something that is not addressed in this document but that you would like to see added to the FAQ, please contact PH Tech’s Provider Relations department at 503-584-2169, selecting Option 2.
Provider offices that see Health Share CCO members will be granted access to PH Tech’s secure web tool, Clinical Integration Manager (CIM). Health Share identified high volume provider offices that will receive priority training. PH Tech’s Provider Relations department will contact these offices directly to work through the user registration process as quickly as possible. Other offices will be directed to PH Tech’s Provider Relations department to begin the registration process.
- Each user of CIM in your office will require a unique username and password.
- The web address of the provider portal is http://healthshareoregon.org/for-providers/member-eligibility.html.
- To register as a new user, you can call CIM support at 503-584-2169, selecting Option 2 for CIM New User Registration or Password Changes. Once you are registered and activated by PH Tech Provider Relations, each user in a provider office may then directly register other users in your office.
- All offices will have access to online training material and a webinar on the PH Tech site. For more information on training, please contact PH Tech’s Provider Relations department at 503-584-2169 or email firstname.lastname@example.org.
- You will continue to check eligibility in the state’s MMIS system to determine the member’s specific CCO under the Oregon Health Plan. For Health Share members residing in the Portland Metropolitan area of Washington, Multnomah and Clackamas counties, you will no longer see a separate eligibility indicating which plan the member is assigned to under Health Share; members will show a single, Health Share CCO line of eligibility in the state’s system.
- You will need to verify which plan within Health Share the member is assigned by utilizing the new CIM system.
- Health Share Customer Service staff will redirect the provider office staff to either the telephone number or email address for PH Tech Provider Relations.
- Provider office staff can contact PH Tech’s Provider Relations department directly at 503-584-2169, selecting Option 2 for CIM New User Registration or Password Changes, or email email@example.com.
No. You will continue to submit your claims as you currently do to the same address or through the same EDI method.
No. You will continue to submit your requests for referrals and authorizations as you currently do to the appropriate Health Share plan partner to which the member is assigned.
- Some providers may already have access through PH Tech’s CIM web application to eligibility, authorizations and claims payment information for Health Share members assigned to Clackamas, Multnomah and Washington counties for mental health care. Provider office staff will continue to use a separate instance of CIM for these processes on this population of Health Share members. The web site for the mental health administration of benefits will remain https://mho.phtech.com.
- PH Tech will automatically roll current user profiles on the MHO CIM site to the Health Share provider portal at https://cim6.phtech.com with the same usernames and passwords as on the MHO CIM site. The Health Share provider portal CIM will replace the current functionality through MMIS to coordinate with the health plan assigned for medical and mental health benefit management. The MHO CIM site will continue to act as the location for actual Health Share mental health benefit management processes (authorizations/claims).
PH Tech Provider Relations will contact high volume provider to verify current users and pre-register additional identified users. Other provider practice offices with current users will have additional security access added for Health Share provider portal eligibility access. Registration of additional users for all offices is available from the main menu at any time after the new access has been granted.
- Providers may initiate a real-time ANSI x.12 270 eligibility request to query coverage information from Health Share on patients for whom services are scheduled or have already been delivered. In real time mode, a provider transmits a 270 request and remains connected while the receiver processes the transaction and returns a 271 response.
- The information included in the 271 response is not intended to provide a complete representation of all benefits, but rather to address the status of eligibility and Health Share plan partner assignment.
- The data included in the 271 response and displayed on the web portal is to be considered true and accurate at the particular time of the transaction. Further questions regarding eligibility data for Health Share members should be directed to Health Share customer service by calling: 503-416-8090 or toll free at 1-888-519-3845. The TTY/TDD number is 711.
- High volume providers will be contacted first to set up 270/271 functionality. If a provider is not one of the high volume providers, but the office has the capability for this process, PH Tech will take their request and add them to a work queue.