Getting credentialed with Insurance Companies in Oregon for LMT's

Steps for getting credentialed with insurance companies in Oregon:

1. Get your NPI (National Provider Identification) Number:https://nppes.cms.hhs.gov/NPPES/Welcome.do

2. Get a Tax ID (unless you plan to use your social security number):https://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Apply-for-an-Employer-Identification-Number-%28EIN%29-Online

3. Fill out the Oregon Pracitioner Credentialing Application Important: Keep an unsigned and undated copy so that you can send it to multiple companieshttp://www.oregon.gov/oha/OHPR/ACPCI/pages/state_app.aspx

4. Fill out a W-9 and keep an unsigned/undated copyhttps://www.irs.gov/pub/irs-pdf/fw9.pdf

5. You will also need copies of your license and liability insurance

6. See the second sheet of this workbook for individual insurance company protocol-follow the procedure for each company you want to credential with

7. Review each companies fee schedules (usually sent to you with the contract during the credentialing process) and decide if you want to accept these

8. Sign and send back contract and any supporting documents to the respective insurance company.

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Tips:

• Keep in mind that it can take 1-4 months to become credentialed with insurance companies
  
• If you don't get an automatic confirmation from the insurance company regarding your application call or email to make sure they have received it 30 days after you send it in
• Respond to all inquiries from the insurance company quickly and make sure you give them all of the documentation they request
• Read fee schedules and contracts thoroughly
  
• Keep great records of your communications with insurance companies and get reference numbers for each phone call
  

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Individual Insurance Company Information

Insurance companyInformationApplication
Regence
Information:  https://www.regence.com/web/regence_provider/credentialing
Application:  https://eapply.or.regence.com/logon.aspx

ASH
Information:  https://www.ashlink.com/ASH/public/Providers/Network/join.aspx
Application:  To begin the process call: ASH Practitioner Recruitment department at 888.511.2743, option 1. Representatives are available to assist you Monday - Friday, 8 a.m. - 5 p.m. Pacific Time.

CAQH (Cigna, Optum, United as well as many others (see full list here.)
Information:  http://www.caqh.org/solutions/caqh-proview
Application:  https://proview.caqh.org/PR/Registration

Kaiser
Information:  http://www.chpgroup.com/prospective-providers-faqs
Application:  http://www.chpgroup.com/request-an-application

Lifewise
Information:  https://www.lifewisewa.com/provider/join-our-network/
Application:  https://www.lifewisewa.com/documents/010207.pdf

Moda
Information:  https://www.modahealth.com/medical/credentialing/overview.shtml
Application:  https://www.modahealth.com/medical/credentialing/forms.shtml

Pacific Source
Information:  http://www.onehealthport.com/provider-source
Application:  https://identity.onehealthport.com/OHPIdentity/Workflows/Register/default.aspx

Oregon Health Co-op
Information:  https://www.ohcoop.org/providers/
Application:  email:  providerengagement@ohcoop.org or call us at 503-765-1676