Miembros de Umpqua Health

Documentos y formularios

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Informed Consent Form – Hysterectomy Consent (Spanish)

Formulario de consentimiento para histerectomía en español del Plan de Salud de Oregon, con secciones para pacientes que pueden otorgar consentimiento y para situaciones de emergencia, conforme a los requisitos de Medicaid.

Informed Consent Form – Hysterectomy Consent

Oregon Health Plan informed consent form for hysterectomy procedures, including sections for patients capable of providing consent and for emergency situations, meeting Medicaid requirements.

Provider Guidance -Diabetes

Umpqua Health Alliance provider guidance on pharmacologic therapy for adults with type 2 diabetes, offering ADA-aligned, patient-centered strategies to support individualized diabetes management.

Provider Guidance -Hepatitis C

Umpqua Health Alliance step-wise guidance for initiating hepatitis C (HCV) treatment in primary care settings, including patient screening recommendations, testing protocols, and treatment criteria for OHP members.

Provider Guidance -Biosimilar FAQs

Umpqua Health Alliance provider FAQ on biosimilar medications, explaining what biosimilars are, how they compare to reference biologics, formulary substitution policies, and implications for OHP members.

Provider Guidance – Asthma and COPD

Umpqua Health Alliance provider guidance on step-wise management of asthma (ages 12 and older) and COPD, including assessment criteria, treatment pathways, and pharmacologic options for respiratory condition management.

Prior Authorization Grid – Behavioral Health (MH/SUD)

Umpqua Health Alliance prior authorization grid for mental health and substance use disorder services, listing procedure codes, coverage requirements, and authorization criteria for behavioral health providers.

Prior Authorization Grid – Imaging

Imaging Prior Authorization Grid providing current authorization requirements and guidance for providers when requesting covered imaging services for Umpqua Health Alliance members.

DME Vendor Grid

A list of DME vendors contracted with Umpqua Health.

Prior Authorization Grid – DME

Umpqua Health Alliance prior authorization grid for durable medical equipment, listing specific HCPCS codes, coverage details, and authorization requirements for DME items billed to the plan.

Prior Authorization – Overview

Overview of Umpqua Health Alliance’s prior authorization requirements for all providers, including which services require PA, medical necessity standards, EPSDT criteria, OHP non-covered service rules, and circumstances under which UHA may not authorize services.

Prior Authorization Grid – Therapies

Umpqua Health Alliance prior authorization grid for therapy services including physical, occupational, and speech therapy, listing code groups and authorization requirements for outpatient therapy requests.