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 providers submitting medical, behavioral health, and substance use disorder service requests for Umpqua Health Alliance members.
Medication Management Referral Form
Referral form for submitting patients to Umpqua Health Alliance’s Medication Management Program, completed by the referring provider and submitted to UHA Pharmacy Services by fax or email.
Pharmacy Prior Authorization Criteria
Pharmacy Prior Authorization Criteria outlining Umpqua Health Alliance requirements and clinical criteria used to review prior authorization requests for covered pharmacy medications and related services.
Medication Prior Authorization Form
Prior authorization request form for prescription drugs submitted to Umpqua Health Alliance’s pharmacy team, requiring clinical documentation and provider information for formulary exceptions or non-covered medication requests.
Professionally Administered Drug (PAD) Prior Authorization Form
Prior authorization request form for professionally administered drugs (PAD), requiring supporting clinical documentation submitted to Umpqua Health Alliance’s pharmacy team by fax or phone.
Pharmacy Prior Authorization Grid
Umpqua Health Alliance’s pharmacy prior authorization grid listing prescription drug categories that require prior authorization, with fax and phone contact information and documentation requirements.
NOABD FAQs (Spanish)
Encuentre respuestas a preguntas frecuentes sobre determinaciones adversas de beneficios.
NOABD FAQs
Find answers to frequently asked questions about adverse benefit determinations.
Appeals & Hearing Request (Spanish)
Utilice este formulario para enviar una solicitud de audiencia a la Autoridad de Salud de Oregón (OHA).
Appeals & Hearing Request
Use this form to submit a hearing request to the Oregon Health Authority (OHA).