Read more: Members may have trouble getting meds at some pharmacies.

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Read about: an important message for providers

Policies and forms

Click here to learn more about BH Qualified Directed Payments (BH QDP)

This section includes medical policies, forms and medical management guidelines for physical and behavioral health. Some documents are provided by CareOregon, the health insurance provider that works with Jackson Care Connect. For dental health information, visit the provider page of the appropriate plan:

Policies: Pharmacy

Forms: Pharmacy

Policy updates and other forms: Pharmacy

Electronic prior authorization Q&As

Authorization guidelines and forms

Eligibility

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 and code lists

Frequently asked questions (FAQs)

Authorization request forms

Miscellaneous policies and forms

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