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OR CareOregon Pharmacy Provider Reconsideration Request Form 2016
Get OR CareOregon Pharmacy Provider Reconsideration Request Form 2016
E documentation supporting your statement (e.g. medical records and clinical studies.) Provide a statement of why you disagree with the original denial reason and/or why you disagree with the criteria we used to make the original decision. Determinations for Oregon Health Plan members will be rendered within 16 days from the date received. For assistance with this form call CareOregon at 503-416-4100 from 8 a.m. to 5 p.m., Monday through Friday. Note: Provider Reconsideration Request must b.
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Reliance FAQ
Therefore, timely filing requires a claim to be received within 365 days from the date of service (OAR 410-141-3565). Initial filing for all other worker types should happen within 120 days from date of service. Resubmission/correction is limited to one year from date of service.
Connect to Care goes out to locations all over the Metro area. Where will we be next? Find out here or call our Customer Services at 503-416-4100 or toll-free 800-224-4840.
For assistance with this form, call CareOregon Advantage at 503-416-4279 or toll-free at 888-712-3258, Monday through Friday from 8 am - 8 pm. Please mark URGENT only as necessary as it delays the review of other requests.
When submitting a corrected claim, you will need to re-submit the ENTIRE claim with any necessary corrections. If you submit only the corrected data and not the entire claim, your claim may not be processed correctly.
Every day, CareOregon helps more than 500,000 Oregonians access free physical, dental, mental health care and prescription drug coverage through the Oregon Health Plan (OHP). Enter our Members section to find out if you're eligible, search for providers, learn about CareOregon benefits, and more.
Timely Submission of Claims (a) Medicaid fee-for-service only claims must be filed within 12 months of the date of service.
Every day, CareOregon helps more than 500,000 Oregonians access free physical, dental, mental health care and prescription drug coverage through the Oregon Health Plan (OHP). Enter our Members section to find out if you're eligible, search for providers, learn about CareOregon benefits, and more.
When submitting claims to CareOregon, you have two options: Send claims electronically using our payer ID 93975.
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