Umpqua Health Providers

Documents & Forms

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

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.

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 outlines requirements and clinical criteria for medications requiring prior authorization, supporting consistent review and approval decisions for covered pharmacy services.