Documents & Forms
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You can also browse our Medicaid members documents or our Medicare website.
134 results
2024 Quality Pool Distribution Plan - Central Oregon
2024 Quality Pool Distribution Plan - Columbia Gorge
2024 Quality Pool Distribution Plan - Lane
2024 Quality Pool Distribution Plan - Marion and Polk
2024 WA Large Group Dental Only Brochure
2024 WA Large Group Medical Plan Comparison - Voyager
Aetna Signature Administrators Nomination
Auto-recoupment enrollment form
Behavioral Health Critical Incident Reporting Form
Behavioral Health Directed Payment Guidance
Behavioral Health Navigation Team
Behavioral Health Panel Provider Onboarding Resources
Behavioral Health: Admission Notification Form
Behavioral Health: Preauthorization Request Form for ABA Services
CAHPS Reference Guide
CCO Region Afghan Refugee Interpreter Vendors Guide
Change Healthcare Talking Points
Claims Research Request Form
Code of Conduct
Community Health Worker Certification Instructions
Community Solutions covered over-the-counter medications
Community Solutions Prior Authorization Criteria
Compliance and Program Integrity Plan
Contact Information Request Form
Contested Refund Form
Contracted Doula Billing FAQ
Corrected Claim Form (Medicaid)
Corrected Dental Claim Form
Corrected Medical Claim Form
COVID-19 Benefit and Reimbursement Policy FAQ
COVID-19 Provider Relief Plan FAQ
Credentialing - Add a Hospital Based Provider - OR WA
Credentialing - Add a Hospital Based Provider - Provider Information Request Form - ID MT
Credentialing - Interest Packet for Facilities and Hospitals - OR
Credentialing - Interest Packet for Providers - OR
Credentialing - Recredentialing Application for Providers - OR
Credentialing Application for Facilities and Hospitals
Credentialing Application for Providers - ID MT
Credentialing Application for Providers - OR with criteria checklist
Credentialing Application for Providers - WA
Credentialing Application Rights
Credentialing Criteria
Dental Claims Referral Form - Dental Essentials
Dental Provider Contracting Interest Form
Diagnostic Imaging Prior Authorization List
Doula Certification Instructions
Drug List - Prior Authorization Criteria
Drug List - Step Therapy Criteria
EFT Payment FAQ
Electronic Remittance Advice (835) and EFT Authorization Agreement
Health Care Interpreter (HCI) Guidelines and FAQ
HEIDIS Guidance for Providers
HRA Plans at a Glance
HRSN Provider Credentialing Application
InTouch for Providers Resource Guide
Language Access Plan
LineFinder FAQ
Medicaid Grievance and Appeals System – Grievances, Appeals and Hearings
Medicaid Grievance and Appeals System – Member Information and Education Requirements
Medicaid Grievance and Appeals System – Notice of Adverse Benefit Determination
Medicaid Provider Enrollment FAQ
Medicaid Provider Validation Application
Medicare Health Outcomes Survey Measures
Medication Restriction Request Form
Metric-HRA Assessment Crosswalk for Idaho, Montana, and Washington
Metric-HRA Assessment Crosswalk for Oregon
Mobile Dentistry and Teledentistry Explained
Naloxone for Opioid Safety
New and Emerging Technologies: Coverage Status
Opioid Medication Coverage FAQ (Commercial)
Opioid Medication Coverage FAQ (Medicaid)
Oral Health Integration FAQ
Ordering, Referring, Prescribing and Attending FAQ
Oregon Organization Medicaid ID Application
Oregon Provider Medicaid ID Application
Overview of Medication-Assisted Treatment (MAT) for Opioid Use Disorder
Overview of Medication-Assisted Treatment (MAT) for Opioid Use Disorder
PacificSource CLAS Standards
PacificSource Foundation Impact Report
PCP Assignment FAQ
Peer Support Specialist Certification Instructions
Peer Wellness Specialist Certification Instructions
Personal Health Navigator Instructions
Pharmacy Network for ID, MT, OR, and WA
Pharmacy Network for ID, MT, OR, and WA (Excel format)
Pharmacy Prior Authorization Request Form (Medicaid)
Primary Care Substance Use Disorder (SUD) Screening and Referral Resource Tool
Prior Authorization Checklist - Blepharoplasty
Prior Authorization Checklist - Bone Growth (Electronic and Ultrasonic) Stimulators
Prior Authorization Checklist - Dental as Medical
Prior Authorization Checklist - Instrumented Spinal Surgery
Prior Authorization Checklist - Reduction Mammoplasty
Prior Authorization FAQ (Medicaid)
Prior Authorization Request Form
Prior Authorization Request Form (Medicaid)
Prior Authorization/Medication Exception Request Form
Provider Access Standards
Provider Appeal Form
Provider Capacity
Provider Contracting Interest Form
Provider Contracting Roster
Provider Enrollment Agreement
Provider Hepatitis C Case Management Form
Provider Information Request
Provider Manual
Provider Network Contact List
Provider Nomination Form
Provider Offshore Operations Attestation
Provider ownership and acquisition change request form
Provider Peer to Peer FAQ
Provider Teledentistry FAQ
Provider Tips and Tricks Clean Claims
Quick Guide to Becoming a Healthcare Interpreter
Recredentialing Criteria
Risk Adjustment and the Optum IOA Tool FAQ
Risk Adjustment FAQ
Risk Adjustment Toolkit
Risk Adjustment Toolkit (Optum)
Smoking Abstinence FAQ
Telemedicine and Telehealth FAQ
Therapy Care FAQ
Traditional Health Worker Reporting Template
Traditional Health Workers FAQ
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