Provider support and resources

As a CareOregon Dental provider, you may have some specific questions for us. Below, you’ll find contact and procedural information for dental providers. If you are looking for specific forms and policies, see Provider Forms and Procedures below.

Provider support and resources

Please call Provider Customer Service at 503-416-1444 or 888-440-9912. Press option 3 for provider.

Click on a topic below for more information.


Provider Support and Resources

Provider forms

This section lists common forms used by CareOregon Dental providers, as well as fact sheets and other information helpful to our members. These documents are in PDF format.

Provider procedures

Click on a topic below to expand the text.


Provider Procedures 2020

  • Referrals and prior authorizations

  • Coordination of benefits

  • Bill the member

Becoming a CareOregon Dental provider 

CareOregon Dental provides dental plan services to two coordinated care organizations supporting and enhancing sensible, localized, coordinated care.

If you are interested in becoming a contracted provider please review our Credentialing Requirements for primary dental care providers and dental specialists.

If you have additional questions or would like to inquire about the contracting process, please contact the CareOregon Dental team at 503-488-2812 or by email at dentalaccessteam@careoregon.org. Thank you for your interest in joining CareOregon Dental’s provider panel!

In your email, please include the following information:
Provider name or clinic name
Specialty
Phone number
Email address
Fax number
Physical address
NPI
TIN
DMAP ID #

Clinical Practice Guidelines

CareOregon Dental is dedicated to supporting our providers with evidence-based clinical guidelines to help achieve the best health outcomes for our members. The CareOregon Dental Quality Subcommittee (DQS) meets regularly to ensure quality standards of care are being met by our providers and to review clinical guidelines for dissemination.


Click on a topic below to expand the text.


Clinical Practical Guidelines

CMS fraud, waste and abuse training

  • Training documents can be found here.
  • CareOregon takes fraud, waste and abuse seriously. If you suspect that benefits aren't being used correctly or want to report a case of fraud, waste or abuse, please contact Ethics Point at 888-331-6524. You also can file a report online at ethicspoint.com.

How to submit claims

Please use the standard American Dental Association (ADA) claim form (2006 or newer).


To submit claims electronically, use EDI Payer ID 93975. For more information on electronic claims, contact Change Healthcare toll-free at 877-363-3666 or visit their website at changehealthcare.com/our-partners/providers.


Mail paper claims to:
CareOregon Claims
PO Box 40328
Portland, OR 97240


For claim inquiries, you have several options:

  • Send your claims inquiries by email to claimshelp@careoregon.orgNote: All emails containing protected health information (PHI) must be sent securely. We are unable to respond to emails that are not sent securely.
  • Call 503-416-1444 or 888-440-9912. Press option 3 for provider.
  • Fill out the Provider Claim Appeal form.

Other provider community resources

Free transportation for your patients

Transportation to physical, dental and mental health care appointments is a free benefit to OHP members. You can help your patients get care by helping get them there! Members can get transit passes, be provided rides or get help paying for gas at no cost.


In Multnomah, Clackamas and Washington counties, contact Ride to Care at 503-416-3955 or 855-321-4899 or visit ridetocare.com.


In Tillamook County, contact NW Rides at 888-793-0439 or visit nworegontransit.org/nw-rides.


What do I need to tell Ride to Care/NW Rides when scheduling a ride for my patient?

  • Your patient's Oregon Health Plan number
  • The date and time of the appointment
  • The name, address and phone number of your patient's destination(s)

 

OneHealthPort 

OneHealthPort provides free, secure access to participating Oregon Health Plan and other payor administrative websites through a single login process. Click here for more information about OneHealthPort Oregon.


CareOregon Dental Logo
© 2020 CareOregon Dental
CareOregon Dental | 315 SW Fifth Ave | Portland, OR 97204
503-416-1444 | 888-440-9912 | TTY 711
Hours: 9 a.m. to 5 p.m. Monday through Friday
Anti-discrimination notice