Important Update for FamilyCare Health Providers
Like you, FamilyCare’s primary focus is on the care of our members and your patients. FamilyCare has reached an agreement with OHA to continue operating until January 31, 2018. We will get members and providers more information as it becomes available.
At this time you should continue to see and schedule FamilyCare patients as you have previously done, including appointments for services through January 31, 2018. FamilyCare will provide OHA with a list of any outstanding referrals and prior authorizations (including any that FamilyCare receives from you by January 31, 2018) to insure OHA has the necessary information from FamilyCare to effect a smooth transition of care.
Please contact OHA for information on who will pay you and how much you will get paid for your services after your patients are disenrolled from FamilyCare. OHA has already released some information related to this transition, which we have provided below. Members with questions can call the Oregon Health Plan client services line at 800-273-0557.
A communication from the OHA on 12/21/17 provides the following information:
“What the transition means for FamilyCare members and providers:
If you are a FamilyCare member: You are still covered by the Oregon Health Plan and all of your benefits remain in place. Before Feb. 1, 2018, a coordinated care organization will be assigned to serve you. You can continue to see your current doctor and other health care providers. Your new CCO will honor FamilyCare’s prior authorizations, appointments (including transportation), procedures and prescriptions. You'll receive a letter with more information soon.
If you area provider: Please continue seeing FamilyCare members per your current contract terms. You will be reimbursed for your services. Your patients’ new CCO will work with you to transition care and pay for pre-approved services.”
Please be assured that FamilyCare will pay for all covered services you provide to FamilyCare assigned members through January 31, 2018. We understand that billings for many of these services will be received after January 31, 2018---FamilyCare will pay for these services as it normally does.
FamilyCare Provider Relations staff are available to answer your questions at 503-471-2149. Questions regarding claims, appeals and grievances, and medical management should continue to go through the normal channels.