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)
Dominant commercial payers
- Regence BlueCross BlueShield of Oregon
- Providence Health Plan
- Moda Health
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
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.
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.