Medical + Dental Health Resources

Medical + Dental Health 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 five medical health plans and one of five 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.  

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 can only request that a member be changed to a Medical or Dental Health Plan with whom the Provider is currently contracted). 

Medical Health Plan Contacts

Provider Contracting
Phone: 800-224-4840
Email: newcontractrequest@careoregon.org
Online

Provider Oregon Medicaid Enrollment
Email: ProviderUpdates@careoregon.org 
Enrollment Form
Enrollment Info

Provider Relations
Phone: 503-416-4100 or 800-224-4840, Option 3 for Provider
Fax: 503-416-1478
Online

Authorizations/Referrals
Policies and Forms
Authorization Guidelines
Frequently Asked Questions

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 97240-0328

You 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
Email: 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
Online: CareOregon or ethicspoint.com 
Phone: 888-331-6524

Provider Manual
Online

Provider Webpage
Online

Provider Portal
Online Portal Login 
Online Portal Tutorials

Provider Contracting
Phone: 503-813-3376

Provider Oregon Medicaid Enrollment
Email: NW-Provider-Enrollment@kp.org

Provider Relations
Phone: 503-813-3376

Authorizations/Referrals
Online

Claims 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 80237-9998

Visit Kaiser’s provider manual for more information regarding claims submission.

Claims Inquiries
Phone: 866-441-1221 or 503-735-2727

FWA Reporting
Phone: 888-774-9100

Provider Manual
Online 

Provider Webpage
Online

Provider Portal
Online

Provider Contracting
Email: PHPProviderContracting@providence.org 

Provider Oregon Medicaid Enrollment
Phone: 503-574-7500 or 800-878-4445

Provider Relations
Online

Authorizations/Referrals
Online
(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 should be mailed to:
Providence Health Plans
Attn: Claims Processing
P.O. Box 3125
Portland, OR.. 97208-3125

Claims Inquiries
Phone: 503-574-7500 or 800-878-4445

FWA 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 503-574-8142

Provider Manual
Online
(must sign into Provlink to view)

Provider Webpage
Online

Provider Portal
Online

Provider Relations/Contracting
Phone: 833-861-2057
Email: OHSUHealthPrvRelations@ohsu.edu

Provider Oregon Medicaid Enrollment
Phone: 503-265-4786
Email: noah.pietz@modahealth.com

Provider Relations
Phone: 503-261-6055
Email: OHSUHealthPrvRelations@ohsu.edu

Authorizations/Referrals
Phone: 833-949-1887 or 833-931-1774
Fax: 833-949-1556
Online: www.modahealth.com/medical/mbt.shtml

Claims Submissions
Medical Claims:
Paper Claims
Mailing Claim Address:
PO Box 40384
Portland, OR 97240

Electronic 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: 844-827-6572

Claims Inquiries
Phone: 844-827-6572

FWA Reporting
Phone: 855-801-2991
Email: StopFraud@modahealth.com

Provider Manual
Online: https://www.modahealth.com/medical/policies.shtml 

Provider Portal
Online: www.modahealth.com/medical/mbt.shtml

Provider Contracting
Phone: 541-684-5580
Email: ORContracting@pacificsource.com

Provider Oregon Medicaid Enrollment
Phone: (541) 684-5580
Email: Medicaidprovnet@pacificsource.com

Provider Relations
Phone: (855) 247-7575
Email: ORproviderservice@pacificsource.com
Online: https://pacificsource.com/_template/t_twoColumn.aspx?id=10737418957 

Authorizations/Referrals
Phone: (800)431-4135
Online: https://authgrid.pacificsource.com/# 

Claims Submissions
Paper Claims
Mailing Address:
PacificSource Community Solutions, Inc.
PO Box 7068
Springfield, OR 97475-0068

Electronic Claims
EDI Clearinghouses:

  • inMediata
  • MCPS
  • Emdeon
  • Office Ally
  • Trizetto Provider Solutions
  • Payer Connection
  • HeW (Health E-Web)
  • RelayHealth

Medicaid Payer ID: 20416

Claims Inquiries
Phone 1-(877)500-2680
Email:  CommunitySolutionsCS@PacificSource.com

FWA Reporting
Phone: 1-(877) 500-2680
Email: CommunitySolutionsCS@PacificSource.com

Provider Manual
https://communitysolutions.pacificsource.com/Document/PSCS_PDF_ProviderManual 

Provider Portal
https://identity.onehealthport.com/EmpowerIDWebIdPForms/Login/PACIFICSOURCE 


Dental Health Plan Contacts

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: 503-952-2000 or 855-433-6825