Intensive, Community-Based Substance Use Disorder Services
Health Share of Oregon is seeking innovative and inventive proposals from organizations who hold a Certificate of Approval (COA) with the State of Oregon as a Substance Use Disorder (SUD) provider. This request for proposals (RFP) is for the creation of a tri-county regional, intensive, and community-based mobile team to serve adult Health Share members with Substance Use Disorders who are not well-served by our existing service array. This program will serve Health Share members in the tri-county region, including Clackamas, Multnomah, and Washington counties.
To improve behavioral health care for our members, we created Health Share Pathways, a single, regional network of providers with standardized administration. Pathways launched in 2016 to make it easier for members to access care and to simplify processes for providers. Providers contract directly with Health Share of Oregon. Clackamas, Multnomah, and Washington Counties administer the health plans.
This page contains manuals, forms, contact information, and updates for providers. Click on the links below to find what you’re looking for:
This section contains the Health Share Pathways provider newsletter for this quarter:
Appendix B: Inpatient/Acute Care Guidelines
Appendix E: Service Authorizations Guidelines & Procedures
Appendix F: Health Share Member Handbook
Appendix G: Regional Pathways Provider Fee Schedules (see "Behavioral Health Fee Schedules + Billing Information" section below)
Appendix H1: Organizational Roster Information Template
Appendix H2: Organizational Roster Attestation
HSTAR_PA Treatment Request Form Instructions: PDF
SUD Medically Monitored Residential Withdrawal Management
Provider Data Management Overview: PDF
Organizational Provider Roster Template: Excel
Organizational Provider Roster Attestation: PDF
Need more help?
If you have additional questions, you can contact the Health Share Contracting and Network Management Department at email@example.com.
If you are in need of further help with ABA resources, feel free to visit our ABA page.
||Health Share Payor ID
||HSOCC, CMHO1, CX034, or CX 032
||VMMH1 or 16259
||CCMMH, VMMH1, or WCHHS
For questions regarding electronic claims submission, please contact PHTech’s EDI Team at firstname.lastname@example.org.
Paper claims should be mailed to:
P.O. Box 5490
Salem, OR 97304
Health Share requires both participating and non-participating providers to submit all claims for behavioral health services within 120 calendar days of the date of service. When Health Share is the secondary payer, the primary payer’s EOB is required and providers are allowed 365 calendar days from the date of service for claims submission.
All providers, both organizational and individual, who will appear on a claim as a submitting, rendering, or attending provider, must be enrolled in Oregon Medicaid and be issued an Oregon Medicaid enrollment number by the Department of Medical Assistance Programs (DMAP) in order to be reimbursed for services rendered. This number is commonly referred to as a “DMAP number.” Providers may e-mail email@example.com for more information or to see if the provider/organization’s NPI is enrolled in Oregon Medicaid and has been assigned a DMAP number.
For questions regarding claim processing/payment status, you may call PH Tech Provider services at 503-584-2169.
For questions regarding specific claim issues or denials, you may contact the behavioral health plan to which the member, or the majority of affected members, belongs:
For more information about billing and provider requirements, please review the Pathways Provider Manual.
Customer Service: 503-742-5335
Toll Free: 888-315-6818 or 888-651-2134 (TTY 711)
Claims Questions/Billing Support: 503-742-5365 or firstname.lastname@example.org
Fraud, Waste and Abuse Reporting: BH-Qualitymanagement@co.clackamas.or.us
Adult Protective Services: 503-650-3000 or secure email: MHAbuseReport@clackamas.us
Customer Service: 503-988-5887 or 888-620-4555 (TTY 503-988-5866)
Claims Questions/Billing Support: email@example.com
Fraud, Waste, and Abuse Reporting: 503-988-6659 or Ashlynn.firstname.lastname@example.org
Adult Protective Services: 503-988-8170 or secure email: email@example.com
Customer Service: 503-291-1155
Claims Questions/Billing Support: firstname.lastname@example.org
Fraud, Waste and Abuse Reporting: 503-846-4515 or email@example.com
Adult Protective Services: 503-846-4515 or secure email: firstname.lastname@example.org
Regional Crisis Lines:
(Confidential support from trained peers. Free to all Oregonians.)
TEXT: teen2teen to 839863
(Free and confidential, 24-hour teen to teen crisis counseling and referral line for youth.)
Oregon DHS Abuse Reporting
This toll-free number allows you to report abuse or neglect of any child or elderly person or persons with developmental disabilities to the Oregon Department of Human Services.