CR13 – Locum Tenens Policy
Umpqua Health Alliance credentialing policy (CR13, Version 6) governing the use of locum tenens (substitute) providers, including Oregon licensure requirements under OAR 847-008-0020, provider notification procedures, and usage limits for the Umpqua Health Network.
CR6 – Credentialing and Re-Credentialing Process
Umpqua Health Alliance credentialing policy (CR6) describing the full credentialing and re-credentialing process for network providers, including application requirements, verification procedures, committee review, and re-credentialing timelines.
CR3 – Screening of Providers
Umpqua Health Alliance credentialing policy (CR3) outlining required screening procedures for providers and subcontractors, including background checks, exclusion list searches, and ongoing monitoring for network participation.
CR1 – Practitioners Within Credentialing Scope
Umpqua Health Alliance credentialing policy (CR1) defining which practitioners fall within the organization’s credentialing scope, including eligibility criteria and requirements for network participation.
Core Competencies for Peer Workers in Behavioral Health Services
SAMHSA’s framework defining core competencies for peer workers in behavioral health services, developed to standardize peer support roles and promote recovery-oriented care across mental health and substance use disorder settings.
Compliance Hotline Poster (Spanish)
Cartel en español sobre la línea directa confidencial de cumplimiento de Umpqua Health Alliance para reportar inquietudes sobre fraude, desperdicio, abuso y privacidad, disponible al (844) 348-4702 o en línea.
Compliance Hotline Poster (English)
Poster informing employees about Umpqua Health Alliance’s confidential compliance hotline for reporting concerns related to compliance, fraud, waste, abuse, and privacy, available by phone at (844) 348-4702 or online.
CE22 – Payment and Authorization of Hospital Admissions
Umpqua Health Alliance corporate policy (CE22) governing payment and authorization of hospital admissions, including provider notification requirements, concurrent review processes, and post-discharge planning coordination.
CE21 – Adverse Benefit Determinations
Umpqua Health Alliance corporate policy (CE21, Version 13) requiring written notification to members when an adverse benefit determination is made, including denials, reductions, or terminations of coverage, in compliance with OAR 410-141-3835 through 410-141-3915 and 42 CFR § 438.400 through 438.424.
CE19 – Substance Use Disorder Services
Umpqua Health Alliance corporate policy (CE19) defining covered substance use disorder services and requirements, including criteria for treatment authorization, levels of care, and coordination with behavioral health providers.
CE12 – Prior Authorizations
Umpqua Health Alliance corporate policy (CE12) outlining prior authorization requirements, processes, and timelines for medical, behavioral health, and pharmacy services, including provider submission requirements and member notification procedures.
CE11 – Covered Services
Umpqua Health Alliance corporate policy (CE11) defining covered services under the Oregon Health Plan, including the scope of benefits, exclusions, and procedures for determining coverage for physical health, behavioral health, and dental services.