As a CareOregon Dental provider, you may have some specific questions for us. Below, you’ll find contact and procedural information for dental providers. If you are looking for specific forms and policies, see Provider Forms and Procedures below.
Provider support and resources
Please call Provider Customer Service at 503-416-1444 or 888-440-9912. Press option 3 for provider.
Click on a topic below for more information.
CareOregon is confirming clinics’ email addresses to ensure that 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 careoregonalerts@careoregon.org. Be sure to identify each email with a job title and name.
Send changes or updates to your clinic(s).
Email: providerupdates@careoregon.org
CareOregon Dental has a qualified team dedicated to working with you and your dental practice. We will contact you when you join our network and introduce you to our team, providing you with our direct contact information. If you have additional questions or would like to inquire about the contracting process, please contact the CareOregon Dental Customer Service team at (503) 416-1444 or 800-224-4840. Press option 3 for provider.
For more information on Oregon Administrative Rules (OARs), Oregon Health Plan rules and what's covered and not covered under the OHP's Dental Services program, click one of these links:
- Many helpful tutorials can be found here.
- The password reminder tool can be found here.
- If you need your password reset or are locked out of the portal, call 877-814-9909.
- For general questions, call CareOregon Customer Service at 503-416-1444 or 888-440-9912 (option 3). You can also email careoregonconnect@careoregon.org.
- Contact a dental access coordinator if you need training.
Schedule interpretation services
Thank you for working with interpreters to serve members who communicate in a language other than English. Our approved vendors are listed below. Click on a vendor to learn more about their services, access scheduling resources, and find contact information.
Immigrant & Refugee Community Organization (IRCO)
Services: On-site, video (VRI), and over the phone (OPI) interpretation, translation
Website: The Immigrant and Refugee Community Organization | IRCO
How to schedule an interpreter with IRCO:
IRCO offers three different pathways for scheduling an interpreter.
- Online scheduling portal: International Language Bank | Language Services Portland (irco.org)
- Email: interpretation@ircoilb.org
- Phone:
- Scheduled on-site and telehealth: 503-234-0068
- On-demand services: 971-271-6489
Translation: Email documents to translation@ircoilb.org
Linguava
Services: On-site, video (VRI), and over the phone (OPI) interpretation, translation
Website Linguava Interpreters | Language Access Solutions | Portland OR
How to schedule an interpreter with Linguava:
Linguava offers four different pathways for scheduling an interpreter.
- Online Scheduling Portal: Interpreter Intelligence Login (linguava.com)
- Email: scheduling@linguava.com
- Phone: 503-265-8515
- Scheduled on-site and telehealth services: Option 1
- On-demand services: Option 2
- Fax: 503-954-1038
Translation: Document Translation | Language Services | Linguava Interpreters
National Interpreting Service (NIS)
Specialty: American Sign Language (ASL)
Services: on-site and video (VRI) interpretation
Website: National Interpreting Service –
How to schedule an interpreter with NIS
NIS offers four different pathways for scheduling an interpreter.
- Online: National Interpreting Service (only use for general information, inquiries, or quotes)
- Email: schedule@nationalinterpretingservice.org
- Phone:
Oregon 503-932-8460
Washington 206-337-4447
Toll Free 877-NIS-SIGN or 877-647-7446
- Fax: 866-411-9742
Oregon Certified Interpreter's Network (OCIN)
Services: On-site, video (VRI), and over the phone (OPI) interpretation, translation
Website: Home - Oregon Certified Interpreter's Network
How to schedule an interpreter with OCIN
OCIN offers four different pathways for scheduling an interpreter, however, the online portal is highly recommended.
- Online Scheduling Portal: Oregon Certified Interpreter's Network Inc. (interpretmanager.com)
- Email: scheduler@oregoncertified.com
- Phone:
- Scheduled on-site and telehealth services: 503-213-3191, Option 1
- On-demand Services: 503-461-6409
- Fax: 971-228-2164
Translation: Translations - Oregon Certified Interpreter's Network
Interpretation services requirements
All contracted CareOregon providers must make interpreting services available to CareOregon members. Interpreters may operate on-site, over the phone, or via computer screen.
In accordance with OAR 950-050-0160, providers must work with qualified or certified interpreters when arranging for or providing services to a person who has interpretation needs. Exceptions are allowed when the provider:
- Has documented proficiency in the preferred language of the person
- Has made a good faith effort to schedule a qualified or certified interpreter and has found that none are available; in this scenario they may schedule an interpreter who is not certified or qualified
- Has maintained records that the person with interpretation needs was offered interpretation services at no cost and the person declined and chose a different interpreter, which could include a family member or friend
Health care providers must provide personal protective equipment to health care interpreters providing services on-site.
Occurrences for which CareOregon covers interpreting services
- Onsite medical, dental, behavioral, or social health appointments
- Scheduling or rescheduling appointments
- Appointment reminders
- Appointment follow-ups
- Relaying test results
- Registration for procedures/admissions
Use only our approved vendors
CareOregon pays for interpreting services so that members can access their covered health care services and benefits. We have contractual arrangements with approved vendors. Please use them when serving CareOregon members. Be sure to verify that your patient is covered by the Oregon Health Plan.
CareOregon pays only for interpreting services that providers coordinate through our approved vendors. If providers choose to coordinate interpretation services with a different vendor, the provider is responsible for paying for those services.
Language resources for providers
Our goal is to ensure that CareOregon members receive high quality, accessible, and culturally relevant interpretation services. Please refer to the information below for additional resources and supports.
- Vendor Intake Guide:This document provides detailed guidance on how to get connected to a vendor, what each vendor requires when scheduling for both initial and follow up appointments, and additional tips or instructions relevant to scheduling an interpreter.
- FAQ Interpretation Services:This document addresses common questions on interpretation services provided by CareOregon. It aims to provide clear and concise answers to help you understand how our services work and how to best work with interpreter.
- OHA Certified or Qualified Interpreter Registry. OHCIA maintains an up-to-date database of all current OHA credentialed interpreters that includes the interpreter’s contact information, languages interpreted, counties served, and availability. Search for an OHA credentialed interpreter here.
Mailing Request for I Speak Cards and “Do you need an Interpreter?” Flyers/Posters: To Request a printing and mailing of ‘I Speak’ cards and “Do you need an Interpreter?” materials, please submit a request via this form 'I Speak' Cards and 'Do you need an Interpreter?' Request Form
Please refer to this guide for additional instructions.
Have questions or feedback on language services? Call Provider Customer Service at 800-224-4840, option 3 or email laservices@careoregon.org. We’re here to help.
How to submit claims
When submitting claims to CareOregon Dental, you have two options:
- Send claims electronically using our payer ID 93975. Please contact Change Healthcare at 877-363-3666 for more information.
- Mail paper claims to:
Claims, CareOregon
PO Box 40328
Portland OR 97240
Please note:
Send electronic claims to payer ID (93975). Send CareOregon Advantage and OHP electronic claims to the same payor ID (93975). Do not bill separately for each plan.
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 help@epayment.center 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/providers/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.
Information on filing claims and pricing
- Claim filing time limits diagram
- Medicare and Medicaid billing and pricing resources
- 2021 Evaluation & Management Coding guide
See Also:
Claim inquiries
You have several options:
- Send your emailed claims inquiries to claimshelp@careoregon.org. Note: All emails containing protected health information (PHI) must be sent in a secure manner. We are unable to respond to emails that are not sent securely.
- Call: 503-416-4100 or 800-224-4840. Press option 3 for provider.
- Fill out the Provider Claim Appeal form.
CareOregon Dental, in collaboration with our Primary Dental Provider Network, developed a streamlined practice tool with the most crucial elements needed to assist our dental providers in evaluating a patient's risk for developing caries and aid in the management of the disease. This tool is the product of extensive clinical dental leadership review of current evidence based CRA tools and discussion on best practices, resulting in a modified version of the American Dental Association’s assessment.
This tool will be used as part of a patient’s caries risk management plan and includes valuable information to be used as a part of motivational interviewing and patient/guardian oral health education. CareOregon Dental’s goal is to improve stratified data collection of our dental population to evaluate and improve health outcomes in our community over time. This tool will help identify populations with the highest risk, develop and implement strategies and evaluate the impact of targeted interventions.
For questions or technical assistance please email oralhealth@careoregon.org
CareOregon takes fraud, waste and abuse seriously. If you suspect that benefits aren't being used correctly or want to report a case of fraud, waste or abuse, please contact EthicsPoint at 888-331-6524. You also can file a report online at EthicsPoint.
For information on how to establish the 270/271 real time batch eligibility verification process, please contact us at (800) 224-4840 or providercustomerservice@careoregon.org after reviewing these initial prerequisites:
- Must be a CareOregon Participating/Contracted Provider
- Must have ability to establish an SFTP Connection: Have FTP solution and provide an SFTP Technical Contact
Provider forms
This section lists commonly used forms by CareOregon Dental providers, as well as fact sheets and other information helpful to our members. These documents are in PDF format.
Provider procedures
Click on a topic below to expand the text.
CareOregon Dental is always secondary to any primary insurance. To ensure proper coordination of benefits, please notify CareOregon Dental with a courtesy call if the member has primary dental insurance.
State and federal regulations prohibit billing Oregon Health Plan recipients for OHP-covered services, except for coinsurance, copayments and deductibles expressly authorized by the General Rules, OHP Rules and/or federal rules.
Members cannot be billed for the following covered services:
- Services that were denied due to lack of an authorization.
- Services that were denied because the member was assigned to a PCP other than the one who rendered the services.
- “Balance billing” for the amount not paid to the provider by CareOregon.
Generally, a provider may legally bill an Oregon Health Plan recipient in the following three circumstances (refer to above OAR for other examples):
- The service provided is not covered by OHP and the member signed a Patient Responsibility for Uncovered Services form before they were seen.
- The member did not tell the provider that they had Medicaid insurance and the provider tried to obtain insurance information.
- Signed DMAP Form 3165.
Becoming a CareOregon Dental provider
CareOregon Dental provides dental plan services to two coordinated care organizations supporting and enhancing sensible, localized, coordinated care.
If you are interested in becoming a contracted provider please review our Credentialing Requirements for primary dental care providers and dental specialists. The OPCA form can be found here.
If you have additional questions or would like to inquire about the contracting process, please contact the CareOregon Dental Customer Service team at (503) 416-1444 or 800-224-4840. Press option 3 for provider. Thank you for your interest in joining CareOregon Dental’s provider panel!
In your email, please include the following information:
- Provider name or clinic name
- Specialty
- Phone number
- Email address
- Fax number
- Physical address
- NPI
- TIN
- DMAP ID #
Clinical Practice Guidelines
CareOregon Dental is dedicated to supporting our providers with evidence-based clinical guidelines to help achieve the best health outcomes for our members. The CareOregon Dental Quality Subcommittee (DQS) meets regularly to ensure quality standards of care are being met by our providers and to review clinical guidelines for dissemination.
Click on a topic below to expand the text.
The CareOregon DQS adopts evidence-based guidelines. Once adopted, they are placed on this webpage (below). Paper copies are available on request. For more information on the guideline selection and adoption process, our Clinical Guidelines Policy & Procedure document is available on request.
For CareOregon’s medical-approved guidelines, visit the CareOregon website.
Topic | Source | Adopted by CareOregon Dental Clinician Committee | Last review by CareOregon Dental Clinician Committee |
Antibiotics | |||
ADA | June 2021 | January 2024 | |
Recommendations for Antibiotic Prophylactic Coverage for Total Joint Replacement(PDF) | AAOS/ADA | April 2017 | January 2024 |
AHA | April 2017 | January 2024 | |
Pain Management | |||
Oregon Opioid Prescribing Guidelines Task Force | Oregon Health Authority | April 2017 | December 2022 |
Oregon Health Authority | December 2018 | December 2022 | |
Radiographs | |||
ADA/USDHHS | April 2017 | June 2024 | |
Optimizing radiation safety in dentistry, Clinical recommendations and regulatory considerations | ADA | June 2024 | June 2024 |
Periodontics | |||
AAP | July 2024 | July 2024 | |
AAP | July 2024 | July 2024 | |
AAP | July 2024 | July 2024 | |
Endodontics | |||
AAE | July 2024 | July 2024 |
Links to free patient education publications and printable materials
- American Dental Association (ADA): All Ages: Mouth Healthy
- American Dental Association (ADA): Kids: Mouth Healthy Kids
- American Dental Association (ADA): Dental X-rays for Kids/Image Gently
Additional resources and helpful links
Opioid Educational Resources
To view each material click and option below:
How to use your prescription safely
Manage pain without opiods
CMS fraud, waste and abuse training
- Training documents can be found here.
- CareOregon takes fraud, waste and abuse seriously. If you suspect that benefits aren't being used correctly or want to report a case of fraud, waste or abuse, please contact EthicsPoint at 888-331-6524. You also can file a report online at EthicsPoint.
How to submit claims
Please use the standard American Dental Association (ADA) claim form (2006 or newer).
To submit claims electronically, use EDI Payer ID 93975. For more information on electronic claims, contact Change Healthcare toll-free at 877-363-3666 or visit their website at changehealthcare.com.
Mail paper claims to:
CareOregon Claims
PO Box 40328
Portland, OR 97240
For claim inquiries, you have several options:
- Send your claims inquiries by email to claimshelp@careoregon.org. Note: All emails containing protected health information (PHI) must be sent securely. We are unable to respond to emails that are not sent securely.
- Call 503-416-1444 or 888-440-9912. Press option 3 for provider.
- Fill out the Provider Claim Appeal form.
Other provider community resources
Free transportation for your patients
Transportation to physical, dental and mental health care appointments is a free benefit to OHP members. You can help your patients get care by helping get them there! Members can get transit passes, be provided rides or get help paying for gas at no cost.
In Multnomah, Clackamas and Washington counties, contact Ride to Care at 503-416-3955 or 855-321-4899 or visit ridetocare.com.
In Tillamook County, contact NW Rides at 888-793-0439 or visit nworegontransit.org/nw-rides.
What do I need to tell Ride to Care/NW Rides when scheduling a ride for my patient?
- Your patient's Oregon Health Plan number
- The date and time of the appointment
- The name, address and phone number of your patient's destination(s)
OneHealthPort
OneHealthPort provides free, secure access to participating Oregon Health Plan and other payor administrative websites through a single login process. Click here for more information about OneHealthPort Oregon.
