Umpqua Health Providers

Documents & Forms

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Appendix A Telehealth Code Descriptions

Reference table listing CPT and HCPCS codes approved for telehealth billing with Umpqua Health Alliance, including required GT modifiers, covering psychiatric evaluations, psychotherapy, E/M services, and other eligible services delivered via telehealth.

How to Submit a Reconsideration

Guide for providers explaining how to submit a claim reconsideration and provide supporting documentation for review by Umpqua Health Alliance.

Member Benefits Summary Flyer – Spanish

Conozca los servicios para miembros disponibles sin costo.

Member Benefits Summary Flyer

Learn about the member services available at no cost.

Guidance for SHARE Funding 2025 Video Tips

Guidance for community partners applying for 2025 SHARE (Supporting Health for All through Reinvestment) funding, covering program eligibility, application instructions, video submission requirements, and examples of projects aligned with the Community Health Improvement Plan.

Patient Coordination of Benefits Intake Form

Intake form for documenting patient coordination of benefits information, used by Umpqua Health Alliance to identify other insurance coverage and coordinate payments between plans.

UHA Members Accident Form – Providers Version

A collection of utilization management policies, procedures, and criteria for covered services to ensure consistent application of review criteria for authorization decisions.

American Diabetes Association Standards of Care

The American Diabetes Association’s Standards of Care in Diabetes, providing comprehensive evidence-based clinical practice recommendations for the prevention, diagnosis, and management of diabetes, referenced by Umpqua Health Alliance as a clinical guideline.

Chronic Obstructive Lung Disease – Global Initiative for COPD

GOLD (Global Initiative for Chronic Obstructive Lung Disease) clinical practice guidelines for the diagnosis, management, and prevention of COPD, referenced by Umpqua Health Alliance as a clinical guideline for providers.

Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders

American Academy of Child and Adolescent Psychiatry (AACAP) clinical practice guideline for assessing and treating anxiety disorders in children and adolescents, referenced by Umpqua Health Alliance as a behavioral health clinical guideline.

Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder

American Academy of Child and Adolescent Psychiatry (AACAP) practice parameter (J. Am. Acad. Child Adolesc. Psychiatry, 2014;53(2):237–257) for the assessment and treatment of children and adolescents with autism spectrum disorder, covering diagnostic considerations, developmental presentation, and evidence-based treatment modalities.

Parameter for the Assessment and Treatment of Children and Adolescents With Posttraumatic Stress Disorder

American Academy of Child and Adolescent Psychiatry (AACAP) practice parameter reviewing evidence-based approaches for assessing and treating children and adolescents with PTSD, referenced by Umpqua Health Alliance as a behavioral health clinical guideline.