Health Share of Oregon holds a CCO contract with the State (OHA) which includes an obligation to coordinate third-party lien (TPL) activities. Health Share subcontracts with five health care delivery systems that provide care to its members, including coordinating TPL activities on behalf of Health Share. Some of the systems subcontract to a third-party subrogation firm. Because of our delegation model, Health Share cannot issue a lien, whoever, we will help you determine the appropriate plan(s) who may have provided care and could have a lien, and will forward your lien request.
Are You an Attorney, or Insurance Agent?
Please submit a Letter of Representation which includes the following information:
- Date of Birth
- Member ID (if known)
- Date of Loss/Injury
- Cause of injury (Motor Vehicle Accident (MVA), slip and fall, malpractice, workers compensation etc.)
- Type of injury (broken leg, traumatic brain injury, etc.)
- Date of injury (DOA)
- Possible liable parties name(s) and address(es)
- Any liability or no-fault insurance and claim number
- Attorney(s) information
- Member’s employer, if workers compensation
Are you a Member?
Your agreement for coverage with OHP requires members to report any potential third-party settlement where a lien may be issued, and possibly pay back the costs of that care to their plan.
You can start this process by either emailing Health Share directly to ask for assistance,
Or, you can self-report by using the PIL online portal at www.reportinjury.org.
Don't know which plan(s) could have provided care or could have a lien for our members?
No worries! We are here to help you determine which plan(s) could have a lien. If you are an attorney, please follow the steps above, and we will respond. If you are a member, please send an email to firstname.lastname@example.org, and we can walk you through the process.
Please know that PIL must be informed of all 3rd parties who are legally liable for all or part of the fees paid by the contractor for services provided to a member within 30 days of knowledge of such potential liability.
Please submit the information listed above by the PIL online portal: www.reportinjury.org.
The Subrogation Process for Health Share Members
- The attorney, member or members representative can send the information above to Health Share
- Health Share will determine which plan(s) could have a lien
- Health Share will forward your lien request to all appropriate plans
- The plans then report the TPL to PIL via the link
- ODHS will response with approval for a lien, or on occasion deny the request with an explanation
- The Plan(s) will then determine if there is lien and any associated lien amount
- The Plan(s) will issue the lien to the attorney, member, or member’s representative
Please note, this process can take several weeks or months.