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Umpqua Health Providers

Documents & Forms

If you can’t find what you’re looking for below, our Customer Care team can help.

Professionally Administered Drug (PAD) Grid

Healthy Start Ages 9 -12 Postcard

Payspan/Zelis Customer Service FAQs

Provider Reconsideration and Claim Dispute Form

Claims Support NDC Validation Process

Submitting Provider Enrollment Requests

Appendix A Telehealth Code Descriptions

How to Upload Additional Documentation

Member Benefits Summary Flyer – Spanish

Conozca los servicios para miembros disponibles sin costo.