Oregon Health Plan (OHP)
Administered by Oregon Health Authority (OHA) through OHA provider enrollment and Coordinated Care Organization (CCO) applications.
Oregon Revenue Cycle Management
Medical billing for Oregon practices — Oregon Health Plan (OHP), Medicare, and commercial payers.
Oregon's Medicaid billing runs through Oregon Health Authority (OHA), and every managed-care plan has its own rules. We bill Oregon Health Plan (OHP), Medicare, and Oregon's commercial payers correctly the first time — and follow every denial through to resolution.
The Oregon payer landscape
Managed-care plans
- Coordinated Care Organizations (CCOs) by region
- OHP fee-for-service (limited populations) [VERIFY]
Dominant commercial payers
- Regence BlueCross BlueShield of Oregon
- Providence Health Plan
- Moda Health [VERIFY]
Why Oregon claims get denied
- Wrong Coordinated Care Organization on file, since a member's CCO is tied to their county of residence and can change
- OHA prior authorization missing for a CCO-specific service requirement
- Behavioral health integration claims split incorrectly between physical and behavioral health CCO components
- Eligibility lapsed and wasn't re-verified before a visit in a region with multiple overlapping CCOs
- Traditional health worker or peer support billing coded outside CCO-approved service definitions [VERIFY]
Oregon behavioral health billing
Oregon integrates behavioral health inside each Coordinated Care Organization rather than carving it out to a separate vendor, so we confirm the member's specific CCO and its behavioral health billing rules before submission — those rules vary meaningfully from one CCO to the next [VERIFY].
Credentialing comes first
Because Oregon assigns members to regional CCOs rather than one statewide plan, credentialing means enrolling with OHA and then separately with every CCO in your service area — see our Oregon credentialing page for the sequence.
See Oregon Credentialing →Billing and books together
Your Oregon claims and your bookkeeping are handled by the same team, so collections, denials, and adjustments always tie back to your financials without a reconciliation gap between separate vendors.
Clearinghouses and EHRs we work in
AvailityOffice AllyWaystarTebraAdvancedMDSimplePracticeKipuTheraNestAveaICANotesBestNotes
5–7% of collections · $950/mo minimum — the same in every state.
Free analysis
Free Oregon Revenue Leakage Analysis
Send a recent AR aging report and denial summary. We'll show you denial patterns by Oregon Health Plan (OHP) plan, days in AR, and the fixes we'd make first.
Send de-identified reports only — we sign a Business Associate Agreement before any PHI is exchanged.