Please call Provider Customer Service at 503-416-4100 or 800-224-4840. Press option 3 for provider.
Care Management Department
Fax: 503-416-3637 or 800-862-4831
Verifying clinics’ email addresses
CareOregon is confirming clinics’ email addresses to ensure we can contact you with system alerts and other critical information. Please send the email address(es) that you want CareOregon to use when contacting your clinic to firstname.lastname@example.org. Be sure to identify each email with a name and job title.
Need to change your clinic info?
Send changes or updates to email@example.com.
Provider relations specialists
View our team assignments list to find your specialist. Fax us at 503-416-1478 or 800-874-3916.
Jackson Care Connect providers are contracted with CareOregon, the health insurance provider that works with Jackson Care Connect. Below you will find the CareOregon Provider Manual, which also applies to CareOregon Advantage/Medicare contracted providers.
- Provider Manual (as provided by CareOregon)
This manual has information on the following topics:
- Referrals and authorizations
- Billing and payment
- Transportation for OHP members
- Provider relations specialists
- Primary care
- Medical record
- Quality improvement
- Medicare Advantage
- Clinical practice guidelines
If you have questions, please contact your provider relations specialist.
CareOregon provides plan services to three Coordinated Care Organizations (CCO) and offers a Medicare Advantage plan supporting and enhancing sensible, localized, coordinated care.
If you are interested in becoming a contracted provider, please review our credentialing requirements (outlined in our CareOregon Provider Manual).
If you have additional questions, or would like to learn more about requesting consideration for a contract, please contact Customer Service at 800-224-4840 or 503-416-4100. You may also complete the New Contract Requests form here. Please be certain to include all applicable fields for consideration.
Thank you for your interest in joining CareOregon’s provider panel!
To submit claims electronically, use EDI Payer ID #93975. Paper claims can be mailed to:
Jackson Care Connect
c/o CareOregon Claims
PO Box 40328
Portland, OR 97240
Electronic HIPAA Transactions
The AMA recognizes electronic health care transactions as a cost saving, efficient way to do business and allows physicians to refocus resources on patient care. The links below provide information regarding various electronic transactions such as submitting claims, receiving payments and remittance advices.
To access your remittance advice electronically:
To receive payments via Electronic Funds Transfer (EFT):
CareOregon provides a couple of options for electronic payment.
- 1. Enroll with CareOregon ePayment Center, administered by Zelis for ACH direct deposit payment, at no cost. Please contact Zelis at 855-774-4392 or firstname.lastname@example.org for instructions on how to register and enroll. Please note, TIN verification is required for registration and enrollment.
- 2. Enroll with Zelis Payment Network for ACH direct deposit payment or virtual credit card for a small fee (this is separate from CareOregon’s free ePayment ACH option noted above). To enroll with the Zelis Payment Network, go
to their website at https://www.zelis.com/provider-enrollment/, or you can call them at 855-496-1571.
- Please note: CareOregon is not involved in any relationship with providers and Zelis Payments. It is strictly between Zelis and you, the provider.
To receive electronic remittance advice:
- 835 form: Please complete and fax back to the number listed on the bottom of the form
- 835 information guide
- Important: 835 enrollment is available through CareOregon ePayment Center, administered by Zelis. If enrolling with the ePayment center, please do not submit this form. Instead, select the option for 835 enrollment upon registration through the ePayment center.
To submit claims electronically:
- To submit claims electronically, use the same EDI Payer ID #93975 for all CareOregon entities (CareOregon Dental, CareOregon Advantage and CareOregon Medicaid claims). Do not bill separately for each plan.
- For EDI claims for which additional paperwork or documentation will be submitted, complete this form and indicate submission in the PWK segment (Loop 2300).
- Contact your practice management system vendor or clearinghouse to initiate electronic claim submission. CareOregon accepts HIPAA-compliant 837 electronic claims through our clearinghouse, Change Healthcare. Change Healthcare will validate the claims for HIPAA compliance and send them directly to CareOregon. Change Healthcare offers several solutions for providers without a practice management system or clearinghouse. Contact them at 866-369-8805 for medical claims and 888-255-7293 for dental claims.
Training documents can be found here.
CareOregon takes fraud, waste and abuse very seriously. If you suspect that benefits aren't being used correctly or want to report a case of waste, abuse or fraud, please contact Ethics Point at 888-331-6524. You also can file a report online at www.ethicspoint.com.
Model of Care Training presentation for providers
Training documents can be found here.
If you have questions please contact Melodie Farmer Quality Assurance Program Manager, Medicare Population Health Partnerships at email@example.com or 503-416-4631.
Quality Metrics Toolkit
2022 CareOregon Quality Metrics Toolkit - all measures (Updated June 2022)