Provider support and resources

For more information on Oregon Administrative Rules (OARs), Oregon Health Plan rules and what's covered and not covered under the OHP's Dental Services program, click one of these links:

• Dental services program rules
• Covered and non-covered services

• Many helpful tutorials can be found here.
• The password reminder tool can be found here.
• If you need your password reset or are locked out of the portal, call 877-814-9909.
• For general questions, call CareOregon Customer Service at 503-416-1444 or 888-440-9912 (option 3). You can also email careoregonconnect@careoregon.org.
• Contact a dental access coordinator if you need training.

Scheduling with our approved vendors

Thank you for working with interpreters to serve members who communicate in a language other than English. Our approved vendors are listed below.

Have questions? Call Provider Customer Service at 888-440-9912, option 3. We’re here to help. 

Language resources for providers

Our goal is to help you and members get the interpreting services that meet your needs. Your facility may find these resources to be useful. 

• “How to schedule no-cost interpreting.” This one-pager summarizes our interpreting service options and how to schedule our vendors. The backside offers tips for a successful multi-language encounter.
• Vendor comparison handout. This document compares the features of our interpreting vendors, so you can choose what works best for your needs.
• “Do you need an interpreter?" This sheet repeats the statement “I need an interpreter” in more than a dozen languages. Patients simply point to their language. Download the CPCCO version here.
• A multilingual Language Access poster. This is another language identification tool, available in two sizes for HSO:11x17 | 12x23 (sandwich board size) and CPCCO: 11x17 | and 12x23 (sandwich board size) to display in your clinic. Patients can point to their language. It also tells them they have a right to free interpreting services, and to file a complaint if they are not satisfied. You can co-brand these with your logo.
• Wallet-sized “I speak” cards. You can print these to give to patients, enabling them to easily request interpretation services. The cards are available in about 25 languages and include a version for those who are deaf, deaf-blind or hard of hearing.
  • OHA “I speak” cards
  • HSO:
    • Customizable "I speak" card for all languages
    • Customizable "I speak" card for rare languages/dialects
    • Dari language "I speak" card
  • CPCCO:
    • Customizable "I speak" card for all languages
    • Customizable "I speak" card for rare languages/dialects
    • Dari language "I speak" card
• Printing instructions. We give printing instructions and offer how to’s for using the materials: How to’s and printing instructions
• Provider portal. You can also request printed materials through our Provider Portal.
• Interpreting FAQs for providers. Download an FAQ with details on our interpreting services and tips for a successful session

Our expectations for interpreting services

All contracted CareOregon Dental providers must make interpreting services available to CareOregon Dental members. Services must be available during and after hours for consultation and provision of care. While interpreting services can be scheduled with short notice, to ensure coverage, please schedule as soon as a member makes an appointment.

Interpreting services should be performed by certified and qualified interpreters. The interpreters may be on-staff or scheduled through a CareOregon Dental approved vendor. They may operate on-site, over the phone or via computer screen. Interpreting should not be provided by a member of the patient's family. Members should never be asked to bring their own interpreter.

Occurrences for which CareOregon Dental covers interpreting services

• Onsite medical, dental or behavioral health appointments
• Scheduling or rescheduling appointments
• Appointment reminders
• Appointment follow-ups
• Relaying test results
• Registration for procedures/admissions

Use only our approved vendors

CareOregon Dental pays for interpreting services so that members can access their covered health care services and benefits. We have contractual arrangements with approved vendors. Please use them when serving CareOregon Dental members. (Be sure to verify that your patient is covered by the Oregon Health Plan.) See “How to schedule no-cost interpreting.”

If providers choose to coordinate interpreting services themselves rather than through CareOregon Dental, they are responsible for paying for those services. CareOregon Dental pays only for interpreting services that providers coordinate through our approved vendors.

Dental referrals

CareOregon Dental members are able to see specialists only by referral from their assigned primary care dentist (PCD). Referrals should be submitted via the Provider Portal. If you need access to the Portal, or are experiencing difficulties submitting a referral, please contact the CareOregon Dental team at dentalaccessteam@careoregon.org or 502-488-2812.

Please include the appropriate documentation and pertinent information along with the referral, which includes:

• Chart notes
• Dental charting
• Current radiographs
• Medical history
• Recent periodontal charting
• Treatment plan

Referrals are processed within one to three business days, but can take up to two to four weeks if additional information is necessary or needs further review.

Prior authorizations

Prior authorization is not required for dental services covered under Oregon Health Plan (OHP). However, authorization may be needed for proposed treatment of non-covered dental services or when requesting to provide dental services that have restrictions and/or limitations or have not been approved via a referral.

Prior authorization requests should be submitted via the Provider Portal. If you need access to the portal, or are experiencing difficulties submitting a referral, please contact the CareOregon Dental team at dentalaccessteam@careoregon.org or 502-488-2812.  Please include appropriate documentation and pertinent information along with the prior authorization request from the list above.

State and federal regulations prohibit billing Oregon Health Plan recipients for OHP-covered services, except for coinsurance, copayments and deductibles expressly authorized by the General Rules, OHP Rules and/or federal rules.

Members cannot be billed for the following covered services:

• Services that were denied due to lack of an authorization.
• Services that were denied because the member was assigned to a PCP other than the one who rendered the services.
• “Balance billing” for the amount not paid to the provider by CareOregon.

Generally, a provider may legally bill an Oregon Health Plan recipient in the following three circumstances (refer to above OAR for other examples):

• The service provided is not covered by OHP and the member signed a Patient Responsibility for Uncovered Services form before they were seen.
• The member did not tell the provider that they had Medicaid insurance and the provider tried to obtain insurance information.
• Signed DMAP Form 3165.

The CareOregon DQS adopts evidence-based guidelines. Once adopted, they are placed on this webpage (below). Paper copies are available on request. For more information on the guideline selection and adoption process, our Clinical Guidelines Policy & Procedure document is available on request.

For CareOregon’s medical-approved guidelines, visit the CareOregon website.

Links to free patient education publications and printable materials

• American Dental Association (ADA): All Ages: Mouth Healthy
• American Dental Association (ADA): Kids: Mouth Healthy Kids
• American Dental Association (ADA): Dental X-rays for Kids/Image Gently

Additional resources and helpful links

• NNOHA: National Network for Oral Health Access
• Ride to Care