1. OHSU Health Services
Provider Training
OHSU Health Services Services Network Pricing Methodologies
DATE: December 16th, 2019
DATE: November 5th, PRESENTED BY: Dorane Brower, Chief Administrative Officer, OHSU Health Services Plan Services

2. Topics
OHSU Health Services
Who We Are
Moda Health’s Experience in Medicaid
PCP assignments
Claim Submission
Referral & Medical Authorization Process
DMAP Provider Enrollment
Appeals & Grievances
Provider Portal
Care Integration and Coordination
Pharmacy
Website
Contact Us
Moda Health’s Medicaid business will be kept separate fro OHSU Health Services. These will not be integrated.

3. OHSU Health Services- Who We Are
Operating as an Integrated Delivery System (IDS) under
Health Share of Oregon, a Coordinated Care Organization
OHSU Health
Legacy Health Pacific Source
Kaiser Permanente
Providence Health & Services
CareOregon
Primary Care & Primary Care Behavioral Health ✔
Specialty Care & Hospitals
Specialty Behavioral Health
Non Emergent Medical Transportation
Dental
Advantage Dental ● CareOregon Dental ● Kaiser Permanente ● ODS ● Willamette Dental Group
OHSU Health Services is responsible for all CCO requirements and reporting up to Health Share. This is a delegated function from the CCO.
Source: “Presentation_OHSU Health Health Share_Comm Teams Meet”

4. OHSU Health Services- Who We Are
OHSU Health Services is a partnership between OHSU Health and
Moda Health
OHSU Health Systems will actively manage all case management, care coordination, flex services and pharmacy (OHSU’s PBM), compliance oversight and provider relations (credentialing and contracting)
Moda Health performs most administrative functions
Medical claims processing
Customer Service
Enrollment and PCP assignments
Finance and Accounting
IT Services
Provider Directory and Network Adequacy Analysis
Provider Services (claim status, change in PCP, etc.)
Compliance and Fraud, Waste and Abuse expertise
Membership Outline
2019: 41,000 Medicaid lives administered by Tuality Health Alliance and Care Oregon
2020: 41,000 Medicaid lives will be administered by OHSU Health Services

5. Moda Health’s Experience in Medicaid
We’re committed to partnering for heathier communities
We have deep experience in standing up and operating a successful Medicaid program
Operating MCO and DCO since 1994
The value, services and infrastructure that we bring to OHSU Health Services:
Transparency
Medicaid claims processing
Customer Service
Enrollment and PCP assignments
Finance and Accounting
IT Services
Provider Directory and Network Adequacy Analysis
Compliance and Fraud, Waste and Abuse expertise
Eastern Oregon Coordinated Care Organization (EOCCO)
EOCCO received its first contract from the Oregon Health Authority in 2012 to administer Medicaid services in Eastern Oregon (all 12 counties).
Moda Health is an equity owner of EOCCO
Administering ~ 51,000 Medicaid lives
Success in meeting quality metrics
Operating with the global budget framework of 3.4%
Implementation of value based payment models
Enhanced PCPCH payments

6. PCP Assignments 6

7. PCP Assignments
Newly enrolled members are unassigned for the first 30 days to allow time for members to choose their own PCP
If no PCP selection is made, OHSU Health Services will auto-assign a PCP for the member
Assignment will be based on geographic location and/or any claim history the member may previously have with a PCP
Requests can be made by member, member’s family member, member’s caseworker, or by PCP on member’s behalf
Forms can be found on OHSU Health Services website
A list of participating PCP can be found on the Provider Directory on OHSU Health Services website
Members may change their PCP up to two times every six months (not enforced for providers)
PCP update requests should be completed within 7-10 business days of submission

8. Claim Submission 8

9. Claims Submission To ensure accurate & timely processing of claims:
Check member’s eligibility prior to each visit for each member in accordance (OAR )
Verify the service performed is a covered service via the Prioritized List of Covered Services & the Prior Authorization list on OHSU Health Services Services Website
Provider is a registered DMAP provider
Applicable referral &/or authorization has been approved prior to services rendered
Submit claims to the appropriate claims address
Standard timely filing is 120 days from the date of service
Medicaid is payment in full
Claims are paid on a weekly basis
We process at least 90% of all clean claims within 30 days and 99% within 90 days.
We currently exceed the requirements for processing
Standard 120 days TF can be waived up to12 months for maternity, newborn, COB, WC, Accident, OMAP denials for members having CCO coverage
Possible heard of claims delay letters being sent out. Not part of the Medicaid line of business. Different lines of business has different time
OSHU:
Prioritized list of Covered services:

10. Claim Submission
Claims received electronically are typically processed more expediently than paper claims.
Electronic Claims:
Claims received electronically are typically processed more expediently than paper claims
To submit claims electronically, please use Payer ID: 13350
If you would like information on billing claims electronically, please contact our Electronic Data Interchange department at
Submit Medical Claims: OHSU Health Services PO Box Portland, OR 97240
If you’re already submitting claims to Moda for other lines of business (ex. Commercial Beacon network) the process will not change when billing for the new OHSU Services members group.

11. Referral & Authorization Process11
A referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring provider believes is necessary but is not prepared or qualified to provide
Retroactive is decision by OHSU Health Services services for a health care service, treatment plan, prescription drug or durable medical equipment that is medically necessary.

12. Transition of Care
Starting 1/1/2020 though 3/31/2020 OHSU Health Services will honor Prior Authorization for all members for 90 days for physical health and pharmacy
Health Related Service will be considered as part of the care coordination process
Services are submitted to OHSU Health via an authorization form
The review is handled via the Case Management team
OHSU Health Services will continue to have discussions with Health Share around the Transition of Care requirements that best fit our members
Allow the member to retain the member’s previous provider until one of the following occurs:
The minimum or authorized course of treatment has been completed
The reviewing provider concludes the treatment is no longer medically necessary (specialty care treatment plans must be reviewed by a qualified provider)
Exceptions: OHSU Health Services is responsible for continuing the entire course of treatment with the member’s previous provider in these cases:
Prenatal & postpartum care
Transplant services through the first-year post-transplant
Radiation or chemotherapy services for the current course of treatment
Prescriptions with a defined minimum course of treatment that exceeds the transition of care period
The grace period applies to all members regardless if there is a referral/authorization for a PCP clinic or a specialty clinic. This also applies to any referral or auth on file to an OON clinic/facility.

13. Submit referrals to OHSU Health Services:
Referrals will be waived for the first 90 days (1/1/2020 – 3/31/2020)
Beginning 4/1/2020 referrals are not required for members within the first 30 days of coverage
Referrals are valid for 180 days or the until the number of visits as been meet (whichever comes first)
Referrals are required for:
Services that are below-the-line, non-funded or unlisted on DMAP’s Prioritized List of Covered services
Request for out-of-network specialist & ancillary providers
PCP to PCP referrals outside of call share
Submit referrals to OHSU Health Services:
Fax:
Phone:
A referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring provider believes is necessary but is not prepared or qualified to provider
Referrals do not become invalid if a member changes his or her PCP during the timeframe of the referral & remain valid until the expiration date or the number of visits has been exhausted, whichever comes first, as long as the member remains eligible with EOCCO
Effective for of 180 days
Out of network or Below the line:  2 visits for a 6 month date span
Courtesy In network & above the line:  4 visits for a 6 month date span

14. Submit referrals to OHSU Health Services:
Referrals are not required for people with Special Health Care Needs (SCHN) or for OB/GYN, Orthopedic services and/or immunizations for in or out-of-network services
Individuals who have high health care needs, multiple chronic conditions, mental illness or substance use disorders and either have functional disabilities, or live with health or social conditions that place them at risk of developing functional disabilities (for example, serious chronic illnesses or certain environmental risk factors such as homelessness or family problems that lead to the need for placement in foster care)
Submit referrals to OHSU Health Services:
Fax:
Phone:
A referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring provider believes is necessary but is not prepared or qualified to provider
SHCN: Individuals who have high health care needs, multiple chronic conditions, mental illness or substance use disorders and either have functional disabilities, or live with health or social conditions that place them at risk of developing functional disabilities (for example, serious chronic illnesses or certain environmental risk factors such as homelessness or family problems that lead to the need for placement in foster care).
Letters will be sent to members that identity members with special health care needs.
Referrals do not become invalid if a member changes his or her PCP during the timeframe of the referral & remain valid until the expiration date or the number of visits has been exhausted, whichever comes first, as long as the member remains eligible with EOCCO
Effective for of 180 days
Out of network or Below the line:  2 visits for a 6 month date span
Courtesy In network & above the line:  4 visits for a 6 month date span

15. Medical Prior Authorizations
Authorization forms can be found on the OHSU Health Services website
The provider must be DMAP registered
Out-of-network providers must have a valid referral on file before authorization request can be processed
Retroactive request after 90 days from the date of service will not be accepted nor approved
Authorizations are not required if OHSU Health Services is secondary, unless the primary policy doesn’t allow the service
In-network DME requires prior authorization when total billed charges on the claim is over $150.00
For members who transition between IDS’ under Health Share, OHSU Health Services will honor prior authorizations from other IDS partners for the first 90 days (beginning 1/1/20 through 3/31/2020) for physical health and pharmacy.
Submit authorization (along with chart notes) request to OHSU Health Services:
Fax: (833)
Phone: (844)
Prior-authorization is decision by OHSU Health Services services for a health care service, treatment plan, prescription drug or durable medical equipment that is medically necessary.
Standard authorizations should be submitted at least 14 business days prior to the planned procedure. Standard turnaround time is 14 calendar days of receipt of the request. OHSU Health Services services may use an additional 14 calendar days to obtain follow-up information if justification to the Authority is obtained. If OHSU Health Services services extends the timeframe, we will notify the member in writing of the reason for the extension
It is possible the member has primary coverage. Majority of Medicaid members with primary coverage is Medicare although there could be members who have primary commercial coverage as-well.

16. Medical Prior Authorizations
Understanding expedited vs. priority PA requests
Expedited authorization decisions will be made no later than 72 hours after the receipt of the request for services that:
Seriously jeopardize the member’s life, health or ability to attain, maintain or regain maximum function
Standard authorization requests, the standard timeframe will apply
14 calendar days of receipt of the request
Priority authorization: request is made within two working days of receipt of the request for:
Example: admission to skilled nursing facility pending
Member’s life, health, or ability to attain, maintain or regain maximum function is not being questioned
Standard turnaround time is 14 calendar days of receipt of the request

17. Prior Authorizations- In House Review
Radiology, Cardiology & Advanced Imaging
OHSU Health Services Services will manually process PA’s for the first 60 days
After this time period, eviCore will process all radiology, cardiology and advanced imaging prior authorizations.
Only specific codes will require a PA during this timeframe (see table on the right)
Standard ultrasounds & routine OB ultrasounds do not require prior-authorization
Beginning 1/1/2020 – 2/29/2020*
Codes Requiring a PA:
CPT
77047
MRI Breast, no contrast
73706
CT angio LE
70546
MRA head w/s contrast
70545
MRA head w/contrast
70549
MRA neck w/s contrast
75574
CTA
75635
CTA abdominal aorta
78816
PET, Tumor imaging
* After 2/29/2020, all radiology, cardiology and advanced imaging prior authorizations will be process by eviCore
OHSU Health Services Fax line:
OHSU Health Services Phone line:
OHSU Health Services will honor any current active PA in place prior. This is only for new request.

18. EviCore Radiology, Cardiology & Advanced Imaging
Beginning 3/1/2020 and forward
Reviews & prior authorizations for radiology, cardiology & advanced imaging
Standard ultrasounds & routine OB ultrasounds do not require prior-authorization
Codes are incorporated on the eviCore prior authorization list on the OHSU Health Services website
Criteria can be found on eviCore website
Retro authorizations are allowed up to 90 days from the date of service
Prior authorizations will be submitted directly to eviCore
Contacting eviCore:
Phone: (844)
Web:
If you are familiar with Commercial Beacon network then you are already working with eviCore for these authorization. Process will not change

19. Prior Authorizations- In House Review
Specialty Pharmacy, reviews & authorizes selected chemotherapy & specialty drugs
Beginning 1/1/2020 and forward
These prior authorizations will be reviewed in house:
Beginning 1/1/2020 – 2/29/2020
OHSU Health Services will manually process PA’s that will be required through Magellan Rx
**All codes requiring a PA are incorporated on the prior authorization list on the OHSU Health Services website.
J3398
Luxturna
J3490
Zolgensma
Zulresso
J9015
Proleukin
Codes are listed on website**
Agents for the treatment of hemophilia and other bleeding disorders
Please review OHSU Health Services website for a full list.

20. Beginning 3/1/2020 and forward
Magellan Rx
Magellan Rx will process prior-authorizations for specialty pharmacy, selected chemotherapy and specialty drugs
Beginning 3/1/2020 and forward
Codes are incorporated on the Magellan Rx prior authorization list on the OHSU Health Services website (list will be added January -February 2020 or earlier)
Prior authorizations will be submitted directly to Magellan Rx
Contact Magellan Rx Specialty Pharmacy:
Phone:
Web:
If you are familiar with Commercial Beacon network then you are already working with eviCore for these authorization. Process will not change

21. Hysterectomies
Hysterectomies performed for the sole purpose of sterilization are not covered
Prior authorization is required for all hysterectomies except radical hysterectomies
A properly completed Hysterectomy Consent form is required for all hysterectomies at the time of prior authorization request
Do not use the Consent to Sterilization form (DMAP 742A or B) for hysterectomies
Oregon law requires an informed consent be obtained from any individual seeking voluntary sterilization (tubal ligation or vasectomy) or a hysterectomy
This form is available on the OHSU Health Services website
Please send the form to
If the form is not received with the prior authorization, we will deny the authorization until the form is received
The State change the requirement for the consent forms. Previously was to be sent in upon claims submission now required at the time of authorization
– Hysterectomies and Sterilization;
4) A properly completed Hysterectomy Consent form (DMAP 741) or a statement signed by the performing physician, depending upon the following circumstances, is required for all hysterectomies:
(a) When a woman is capable of bearing children:
(A) Prior to the surgery, the person securing authorization to perform the hysterectomy must inform the woman and her representative, if any, orally and in writing, that the hysterectomy will render her permanently incapable of reproducing;
(B) The woman or her representative, if any, must sign the consent form to acknowledge she received that information.
(b) When a woman is sterile prior to the hysterectomy, the physician who performs the hysterectomy must certify in writing that the woman was already sterile prior to the hysterectomy and state the cause of the sterility;
(c) When there is a life-threatening emergency situation that requires a hysterectomy in which the physician determines that prior acknowledgment is not possible, the physician performing the hysterectomy must certify in writing that the hysterectomy was performed under a life- threatening emergency situation in which he or she determined prior acknowledgment was not possible and describe the nature of the emergency.
(5) In cases of retroactive eligibility: The physician who performs the hysterectomy must certify in writing one of the following:
(a) The woman was informed before the operation that the hysterectomy would make her permanently incapable of reproducing;
(b) The woman was previously sterile and states the cause of the sterility;
(c) The hysterectomy was performed because of a life-threatening emergency situation in which prior acknowledgment was not possible and describes the nature of the emergency.

22. Voluntary Sterilization
Consent for voluntary sterilization must be an informed choice
Ages 15 years or older who are mentally competent to give informed consent with at least 30 days but not more than 180 days must pass between the date of the written consent and the date of the sterilization
The member must sign and date the consent form before it is signed and dated by the person obtaining the consent
The person obtaining the consent must sign the consent form anytime after the client has signed but before the sterilization is performed
Consent forms are required at the time of prior-authorization request
Not required if the procedure caused sterilization but the purpose of the procedure is something other than sterilization
The form can be found on OHSU Health Services website
Please send the form to with authorization request
– Hysterectomies and Sterilization;
(9) Voluntary Sterilization:
(a) Consent for sterilization must be an informed choice. The consent is not valid if signed when the client is:
(A) In labor;
(B) Seeking or obtaining an abortion; or
(C) Under the influence of alcohol or drugs.
(b) Ages 15 years or older who are mentally competent to give informed consent:
(A) At least 30 days, but not more than 180 days, must have passed between the date of the informed written consent (date of signature) and the date of the sterilization except:
(i) In the case of premature delivery by vaginal or cesarean section the consent form must have been signed at least 72 hours before the sterilization is performed and more than 30 days before the expected date of confinement;
(ii) In cases of emergency abdominal surgery (other than cesarean section), the consent form must have been signed at least 72 hours before the sterilization was performed.

23. DMAP Provider Enrollment23

24. DMAP Provider Enrollment
All rendering, billing providers & facilities must be DMAP registered in order to get paid for the services for seeing OHSU Health Service’s members
All attending providers
All prescribing physician & pharmacies
Enrollment is for 3 years or until the license expires/lapses
Typically days for provider to become enrolled once application is received
Sends term letters 30/60/90.
FFS is separate enrollment than CCO coverage. If enrolled with CCO & want to see FFS patients need to enroll through DMAP. If you enroll directly through DMAP can see both CCO coverage & DMAP but if you previously enrolled with CCO then DMAP will make you enroll through CCO again.
FQHC/RHC are required to enroll with FFS & Encounter only.
Can only enroll back to 18 months.

25. DMAP Provider Enrollment
Can also verify via MMIS
If shows valid in MMIS but not on our spreadsheet then most likely will show up on next week’s file

26. Appeals and Grievances26

27. Member Grievances
A complaint is an expression of dissatisfaction to OHSU Health Services or a provider about any matter that does not involve a denial, limitation, reduction or termination of a requested covered service
Examples include, but not limited to, access to providers, waiting times, demeanor of medical care personnel, quality of care & adequacy of facilities
Providers are encouraged to resolve complaints, problems & concerns brought to them by their OHSU Health Services patients but if you cannot resolve a complaint yourself, please inform the member that we have a formal complaint procedure
There is no timeline for when a grievance can to be filed
Forms can be found on OHSU Health Services website
OHSU Health Services will reach out to you to for assistance in resolving grievances.
Please respond as quickly as possible as there are short turnaround times required for these grievances.

28. Member Appeals
An appeal is a request by an OHSU Health Services member or his/her representative to review an OHSU Health Services decision to deny, limit, reduce or terminate a requested covered service or to deny a claim payment
A member appeal can be submitted to OHSU Health Services by a member or a provider, on the member’s behalf
The member’s written consent is required
The appeal must be requested within 60 days of the date on the member’s Notice of Action letter & must be in received in writing
If the appeal decision upholds the denial, the member is informed of the right to request an administrative hearing through OHA

29. Written appeals can be sent to:
Member Appeals
OHSU Health Services appeal staff facilitates the member complaint & appeal process & seeks input from appropriate parties to reach a decision about the complaints & appeals
The appeal staff sends a written resolution to the member or his/her representative within 5 days of receipt of a complaint & within 14 days of receipt for an appeal (with possible extensions)
Forms can be found on OHSU Health Services website
Written appeals can be sent to:
OHSU Health Services
Attn: Appeals Unit
PO Box 40384
Portland, OR 97240
Fax:
Attention: Appeals Unit
OHA Appeal and Grievance website:
Appeal and hearing form:

30. Provider Appeals
Initial applicant provider & participating providers have 60 calendar days following the receipt of the medical director’s letter of the OHSU Health Services decision to take adverse action against the provider’s or practitioners participating status
A written request would be mailed to the medical director by certified mail
If a provider has a question regarding claims status, member eligibility, payment methodology, medical policy or third-party issues, please send a written request to:
OHSU Health Services
Attn: Appeals Unit
PO Box 40384
Portland, OR 97240
Forms can be found on OHSU Health Services website

31. Provider Portal 31

32. Provider Portal
Please use the following website: Moda Health Benefit Tracker
In the portal, you can validate the following:
Eligibility & benefits
PCP history
Referral inquiry
Claims status
Tax Identification Number driven
Request and account:
Step 1: Complete an Electronic Services Agreement for your organization and assign a contact person. This agreement is part of HIPAA privacy requirements and needs the signature of someone representing the entire organization (i.e. an owner, officer, administrator or patient accounts director).
Step 2: Register online to get your login. For privacy reasons, your browser must support 128-bit encryption to use Benefit Tracker.
To cancel your account, please download the Medical Account Access Removal Request.
Questions?
View the demo or contact the Benefit Tracker Administrator at or or via at

33. Provider Portal
Request and account:
Step 1: Complete an Electronic Services Agreement for your organization and assign a contact person. This agreement is part of HIPAA privacy requirements and needs the signature of someone representing the entire organization (i.e. an owner, officer, administrator or patient accounts director).
Step 2: Register online to get your login. For privacy reasons, your browser must support 128-bit encryption to use Benefit Tracker.
To cancel your account, please download the Medical Account Access Removal Request.
Questions?
View the demo or contact the Benefit Tracker Administrator at or or via at

34. Provider Portal: Eligibility
Jane Doe
AB123C4D
OHSU Health IDS
OHSU Health

35. Provider Portal; Claims

36. Provider Portal: PCP

37. Provider Portal: Referrals

38. Care Integration and Coordination38

39. CCO 2.0 – Five Primary Areas of Action Focus
Behavioral Health and Dental Health Integration
Social Determinants of Health
Health Information and Technology – Data Integration
Care Coordination and Integration
Value-Based Payments

41. Care Integration and Coordination Team
OHSU Health Plan
Member
Integrated Community Care Manager
(RN/SW)
Health Engagement Specialist
Care Integration Specialist
Clinical
Pharmacist
Panel Coordinator
Community Outreach Specialist
(CHW)

42. Care Integration and Coordination Team
CICP Director
Maggie Klein
CICP Manager
Vacant
West Side
Integrated Community Care Managers (RN/SW)(3)
Health Engagement Specialists (2)
Care Integration Specialists (2)
Core
Pharmacist (1)
Panel Coordinators+
East Side
Health Engagement Specialists (3)
Wellness Promotion and Outreach Supervisor
Cristela Daniel-Valdez
All Regions
Community Outreach Specialists (2)
Clinical Integration Specialist – Foster Program (1-TBD)

43. Health Plan Member Populations - Differentiated
High
Risk
Rising Risk
Care Coordination
Wellness Promotion

44. Health Plan Member Populations Defined
High Risk
Members with multiple, ongoing and complex medical or behavioral issues and social concerns
Managed by Multi-disciplinary Integrated Care Team
Integrated Community Care Managers (ICCM - RN) have lead – if Behavioral ICCM – SW have lead
Rising Risk
Members with acute, time-limited medical needs or new onset conditions
Medical Condition or Social Situation
Less Intense Care Integration and Coordination
Care Integration Specialists or Health Engagement Specialists have lead – ICCM RN/SW as needed
Care Coordination
Members with single (or non-complicated) conditions
Members with specific needs due to Social Determinants of Health
General Care and Service/Need Coordination
Care Integration Specialists have lead – Community Outreach Specialists (CHW/THW) as needed
Wellness Promotion
Members who are healthy to provide wellness support and preventive services
Community-based Education programs and services
Foster Children Coordination
First Tooth (Dental Program)
Wellness Supervisor, Care Integration Specialist – Foster Care, and Community Outreach Specialists

46. Pharmacy 46

47. Pharmacy How can I access the pharmacy formulary?
Beginning January 1st 2020, the OHSU Health formulary will be available at
Prior to January 1st 2020, the existing THA formulary can be referenced at
Google Chrome is the preferred browser to navigate the formulary URL search tool.

48. Pharmacy How do I submit pharmacy authorization requests?
Beginning January 1st 2020, pharmacy authorization requests for OHSU Health Services members should be sent to OHSU PBM Services
Prior to January 1st 2020, requests should be sent to the member’s current Medicaid insurer
OHSU Health pharmacy authorization request forms are located at and via the CoverMyMeds Portal
A completed form and supporting clinical documentation is required for authorization review
The fax number for OHSU PBM Services is
What number should I call with questions about pharmacy claims or authorization requests?
Contact OHSU Health at and select option “1”
Provider services are available Monday-Friday 8am-5pm

49. Pharmacy
Will active pharmacy authorizations on-file with the member’s previous Medicaid insurer be valid after January 1st?
Active pharmacy authorizations obtained from the member’s previous Medicaid insurer prior to January 1st 2020 will be honored for up to 90 days during the transition period
A pharmacy authorization request will need to be submitted to OHSU PBM Services to ensure continued coverage prior to the transition period ending
Where can I locate pharmacy clinical coverage guidelines?
Pharmacy prior authorization and step therapy clinical coverage guidelines can be found at and upon request

50. Pharmacy
How are mental health medications covered for OHSU Health members?
Medications used for treatment of mental health conditions are covered by the Oregon Health Authority
These medications will appear as “Non-Formulary” on the formulary URL search tool as coverage is not through OHSU Health Services
What pharmacies are in-network?
Most major pharmacy chains aside from CVS and Walgreens are in-network
Beginning January 1st 2020, a pharmacy locator tool will be available at

51. Website 51

52. Website

53. Manager, Medicaid Services
Contact Us
Primary point of contact for OHSU Health Services is Customer Service Phone Hours of Operation: 7:30 a.m. to 5:30 p.m., Weekdays
Provider Relations Representative Noah Pietz
Manager, Medicaid Services
Kayla Jones
Of course if you are not getting a timely or accurate resolution nor being treated the way you feel you should be treated please do not hesitate to reach out to myself. We provide oversight to these areas

54. Questions?