Effective 6/1/18, we will be moving authorization requests (initial or concurrent requests) from fax to the Connect provider portal, for the following mental health levels of care: subacute, Children’s Psychiatric Day Treatment Services (PDTS), and Children’s Psychiatric Residential Treatment Services (PRTS). All relevant clinical supporting documentation should also be submitted via the Connect portal. 

Policies and Forms

This page includes medical policies, forms and medical management guidelines for physical health. The documents are provided by CareOregon, a partner in Jackson Care Connect.

Behavioral Health Guidelines and Forms

Policies – General

Policies – Pharmacy

Forms – Pharmacy

Policy Updates & Other Forms - Pharmacy

Authorization Guidelines and Forms


Use the Provider Portal to verify a member’s eligibility with Jackson Care Connect.

Authorization Guidelines

Changes are posted on the 15th day of the calendar month (or the next business day).

Diagnostic and Treatment Procedures - CPT Code Grid

DME - Authorization & Code Lists

Frequently Asked Questions (FAQ's)

Authorization Request Forms Miscellaneous Policies and Forms

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