Compliance Program
Code of Conduct
Compliance Program and FWA Handbook
CO1 – Fraud Waste and Abuse
CO6 – Compliance Training
CO21 – External Risk Response Process
Compliance Hotline (English) | (Spanish)
Handbooks
Provider Handbook
Member Handbook (English) | (Spanish)
Recommended Trainings
HIPAA Training
Prior Authorization Training
Patient Centered Counseling Training
CME Trainings
Policies
Member Services
MS1 – Member Assignment and Reassignment
MS3 – Member Rights
MS5 – Requests for Interpreter or Alternative Format
Clinical Engagement
CE01 – Grievance Appeals and Hearings
CE03 – Wraparound
CE05 – Utilization Review
CE11 – Covered Services
CE12 – Prior Authorizations
CE16 – Intensive Care Coordination Services
CE19 – Substance Use Disorder Services
CE21 – Adverse Benefit Determinations
CE22 – Payment and Authorization of Hospital Admissions
CE28 – Transition of Care
Credentialing
CR1 – Practitioners Within Credentialing Scope
CR6 – Initial Credentialing Process
CR11 – Re-Credentialing Procedure
CR16 – Non-Licensed Provider Credentialing and Re-Credentialing Process
CR19 – Traditional Health Worker Requirements
CR20 – Non-Licensed Provider Qualifications and Competencies
Third Party Liability Recovery
F18 – Third Party Liability Recovery
Transitional Care
TC1 – Transitional Care for Acute Care
Provider Network
PN6 – New Provider Orientation and Training
PN7 – Network Adequacy
PN8 – Monitoring Network Availability
PN9 – Monitoring Network Access
PN11 – Provider Selection Process
For all training questions, please contact us at UHNProviderServices@umpquahealth.com. If you have a specific question about provider orientation and trainings, click here to view a contact sheet for several UHA departments.