Providence may require prior authorization for certain services. Let us help you find the plan that best fits you or your family's needs. Working with us means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. PPP PAYS ALL ADMINISTRATIVE AND PAYROLL COSTS ON BEHALF OF PHP AND PHA, WHICH ARE LATER REIMBURSED TO PPP.PROVIDENCE PREFERRED PROVIDER PROGRAM (THE PROGRAM), AS PART OF PROVIDENCE PLAN PARTNERS (PPP), IS A NETWORK OF MEDICAL PRACTITIONERS, HOSPITALS AND ANCILLARY MEDICAL PROVIDERS THROUGHOUT OREGON AND SOUTHWEST WASHINGTON DESIGNED TO MANAGE THE COST, DELIVERY, AND QUALITY OF HEALTHCARE IN THESE COMMUNITIES. NOTE: TTY, or text telephone relay, services enable those with hearing and/or speech impairments to communicate with others by telephone. Referrals are not required; however, your primary care provider may refer you or you may refer yourself to an in-network provider. He joined the company in 2014 to manage compliance for its commercial lines of business, as well as regulatory and government affairs. This data is only available if this organization has at least one year of electronically-filed Form 990 data filed within the last six years. PDF Bservatory on Ourism for Slands Conomy Services determined to be investigational, not medically necessary, or cosmetic in nature are not covered by your plan. Learn More Timshel actively supports her community and has served as a board member for Catholic Charities, president of the Board for Candlelighters for Children with Cancer, and community board member for the Clackamas County Compensation Committee. At Providence, our strength begins with understanding. He completed his undergraduate studies at the University of Nebraska-Lincoln, majoring in Journalism and Political Science. See a list of conditions supported by Providence Care Management and learn more about the resources available to you based on your specific condition. By listening to our members and exploring innovative solutions with our providers and communities, we help Oregonians prevent illness and live better lives. Scott Burton serves as Market President for the Commercial lines of business at Providence Health Plan (PHP), leads the Sales and Account Services teams, manages operations of all health plan commercial business, and steers the development of PHPs commercial strategy. In her own time, she actively mentors and develops others, is a founding member of the womens only executive leadership group, Chief of San Francisco, and volunteers as a Youth Girl soccer coach. Before joining Providence Health Plan, Cheryl served as Vice President of Growth Operations for commercial and consumer markets at Blue Shield of California where she successfully reimagined and launched strategic operating models across multiple lines of business. PROVIDENCE PLAN PARTNERS is a Social Welfare Organization headquartered in RENTON, WA. Enrollment in Providence Health Assurance depends on contract renewal. See rating report below to learn why this organization is not currently eligible. Practitioners and hospitals in our networks must meet our credentialing requirements. These models served to close the gap between basic operations and the fundamental change required to drive growth, optimize functional operations, and improve the capabilities and services offered through innovative technology. Michael Mathias joined Providence Health Plan (PHP) as Chief Information Officer in August of 2022. Providers must be contracted with ASH to be considered participating with Providence Health Plan. To locate an in-network provider, refer to the provider directory. Meet with a licensed mental health provider that best suits your needs, fully confidential always. BOTH ARE REGULATED HEALTH PLANS WITH ACTIVITY IN OREGON AND WASHINGTON, AND ARE RECOGNIZED AS EXEMPT UNDER IRC SEC. Caresse has over 20 years of product and marketing leadership experience and is classically trained in packaged goods with twelve years of health care experience. CareOregon and Providence have a long history of working together and with community providers and stakeholders to serve Oregonians, driving population health initiatives and delivering on the promise of Oregons health care transformation. Program 1 SEE SCHEDULE OPROVIDENCEAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. Pharmacy Services . Nathan Perrizo - President - Health Plan Markets - LinkedIn Prior to her role as Market President, Shannon served as Associate Vice President of Medicare and Individual Sales, leading sales teams in Oregon, Washington and California. We take responsibility for providing the very best health care services and benefits possible; your responsibility is to know how to use them well. This compensation data includes salary, cash bonuses, and expense accounts and is displayed exactly how it is reported to the IRS. From https://projects.propublica.org/nonprofits. A veteran of Medicare sales, she is known as a trusted subject matter expert in the field as well as a successful, authentic leader. Create an account and get the information you need to best manage your health. Disclaimer |Non-discrimination and Communication Assistance |Notice of Privacy Practice |Terms of Use & Privacy Policy, Browse value-added services & buy-up options, Non-discrimination and Communication Assistance |. In the event of an emergency, call 911 or go directly to the nearest emergency facility. The directory is located at ProvidenceHealthPlan.com/findaprovider. loading and try your donation again. Sign up to get ProPublicas biggest stories delivered straight to your inbox. Lina joins Providence Health Plan following a 23-year career with Blue Shield of California, where she led a multitude of service lines including financial planning, Medicare, strategy, and corporate development. Learn more. In-network providers are listed in the provider directory. Access everything you need to sell our plans. Most specialty, hospitalization, and behavioral health services require a referral, which is a written order from the primary care provider to see a specialist or get certain medical services. Information listed in this directory is not guaranteed and may be subject to change without notice. Pharmacy + Drug List - yamhillcco.org 05/21/2023. Some services, including inpatient hospital services, require prior authorization. Personal Option plan, and Oregon and Washington Individual plans: These plans require that services be rendered by an in-network provider. The partnership will combine the collective strengths of both organizations and ensure CareOregon and PPP [] PPP CHARGES THESE ADMINISTRATIVE EXPENSES TO PHP AND PHA BASED ON TIME NECESSARY TO PERFORM THE SUPPORT SERVICES. For additional information, refer to your member materials available in the Providence Health Plan secure member portal, myProvidence. This means that you must be able to access mental health or substance use disorder treatment services within 15 business days according to Washington law. Regena joins Providence Health Plan from Medecision, a digital health and consulting company in Dallas, where she served as vice president of marketing and communications. Technology must improve health outcomes. Company Description: Key Principal: Jack Friegman See more contacts Industry: Insurance Carriers , Insurance Carriers and Related Activities , Finance and Insurance , Health insurance carriers Providence Health Plan provides services to a wide range of clients, including self -funded employers, AS SUCH, THE PROGRAM AIMS TO PROVIDE COORDINATED, HIGH QUALITY MEDICAL CARE TO WORKERS WHO SUFFER WORK-RELATED INJURIES OR ILLNESSES AND FOCUSES ON EARLY RETURN-TO-WORK STRATEGIES THAT KEEP EMPLOYEES PRODUCTIVE DURING RECOVERY. All rights reserved. | Tax-exempt since May 2003, https://projects.propublica.org/nonprofits. Learn more Producers Everything you need to pair your clients with the perfect plan. Prior to his time at Providence, Brad worked for ODS Health Plans (now Moda Health), as well as a property and casualty insurance company. We're here to supply you with the support you need to provide for our members. Throughout her nearly 20 years of experience in healthcare, she has acquired a wealth of knowledge executing key roles across health plan operations, sales, and other lines of business. He joined Providence Health Plan in May 2022 and is based in Oregon. We're here to supply you with the support you need to provide for our members. WITHOUT PPP, PHP AND PHA WOULD NEED TO PERFORM THESE SERVICES FOR THEMSELVES. Find a doctor, clinic, pharmacy, or other provider in the Ayin Administrative Health Solutions network, https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status, https://fortress.wa.gov/doh/providercredentialsearch/, Non-discrimination and Communication Assistance. Address: 1801 Lind Ave SW Renton, WA, 98057-3368 United States Phone: We're here to supply you with the support you need to provide for our members. PDF Continuing Disclosure Quarterly Report Providence St. Joseph Health and Resources, services, and support to help you better serve your patients and run your practice. PHP strives to improve member health outcomes by ensuring they receive recommended screenings. A dynamic leader with more than a decade of healthcare knowledge and experience, Scott is committed to leading health care transformation to deliver the best possible experience for employers and their employees. Technology must meet government approval to market by appropriate regulatory agency as applicable. In his role, Michael drives the strategy and adoption of information technology (IT) systems for the organization. Stay covered: learn more about Oregon Health Plan eligibility. Learn more about prior authorization. I want to see hotel recommendations when using Rome2Rio Rome2Rio uses cookies to help personalize content and show you personalised ads. Get information about filing an appeal and external review(PDF), Classification of Mental Health and SUD treatment and access standard. Please take time to read and understand your benefits. Let us help you find the plan that best fits you or your family's needs. If you would like to file a complaint with the Washington state Office of the Insurance Commissioner you may contact them at www.insurance.wa.gov or call 1-800-562-6900. During her time with Medecision, Regena was responsible for identifying and achieving growth objectives, and led digital marketing, brand management and communications efforts for the company. Save big on fitness and wellness products, services, and memberships. Steps an enrollee may take if they cannot access services in the required timelines. Our member mailing program aims to increase completion of these important screenings through both education mailings and gap mailings. Copyright 2023 Candid. He currently serves on the Board of the Oregon Medical Association and the Leadership Advisory Committee of the Oregon Data Collaborative. Small organizations filing a Form 990N "e-Postcard" are not included in this data. THEREFORE, BY PROVIDING THESE OPERATIONAL SERVICES, PPP ALLOWS PHP AND PHA TO FREE UP AND RE-ALLOCATE RESOURCES IN ORDER TO IMPROVE QUALITY AND BREADTH OF HEALTHCARE SERVICES TO THE SURROUNDING COMMUNITY. Copyright 2023 Providence Health Plan, Providence Plan Partners, and Providence Health Assurance. Providence Health Plan delegates administration of alternative care to American Specialty Health (ASH). Want to see how you can enhance your nonprofit research and unlock more insights? We strongly believe joining our two community-focused organizations will improve the health care status of our members, increase their access to care, and create a national model to better serve Medicaid and Medicare beneficiaries, said Eric C. Hunter, president and chief executive officer of CareOregon. Resources for persons experiencing a mental health crisis. For more information, call 888-511-2743 or visit ASH online. If an emergency situation occurs, you should take immediate action and seek prompt medical care. In her role, Regena serves as a key communications strategist and advisor and plays a critical role in the planning and overseeing of administrative, financial, and operational activities. The scientific evidence must document conclusions that are based on established medical facts. The provider will bill you for the amount due, if any. Were here to help. Application of technology must be appropriate, in keeping with good medical standards and useful outside of investigational settings. With more than 25 years of healthcare industry experience, she has been instrumental in leading high-performing teams with several organizations. Our network of all kinds of health care providers (physical, dental and behavioral health) has agreed to work together. Account Registration Welcome to myProvidence! Let us help you find the plan that best fits your needs. Their decisions are based on information provided by professional assessment and policy development organizations, as well as other medical experts. Robert Gluckman joined Providence Health and Services in 1992 and has served as Chief Medical Officer for Providence Health Plan since 2010. Sign in. Additional information regarding behavioral health services and resources are available to Providence Health Plan members. CareOregon is a non-profit community benefits company involved in health plan services, reforms and innovations since 1994. The funds contributed to an account are not subject to federal income tax at the time of deposit.
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