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
Umpqua Health Alliance prior authorization grid identifying imaging services that require prior authorization, with coverage details and submission instructions for radiology and diagnostic imaging providers.
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.
Behavioral Health Prior Authorization Provider FAQ
Find answers to frequently asked questions about behavioral health PAs.
Provider Portal Instructions
Step-by-step instructions for providers to sign up for the Umpqua Health Alliance provider portal, including account registration, email verification, and how to access claims and member information online.
Medical, Behavioral and SUD Prior Authorization Form
Prior authorization request form for medical, DME, mental health, and substance use disorder services submitted to Umpqua Health Alliance, including member and provider information fields and supporting documentation requirements.