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  • Care Management

    Search directories for primary and specialty care providers within your patient's plan network to refer for care.…

  • Benefits and Eligibility

    Use your provider portal to check claims and eligibility. Need help? Download our Provider Connect tutorial for step-by-step instructions.…

  • Special Needs Plan Model of Care Training

    Attest to completing the SNP-MOC training through the form provided. Your training will not be documented as complete until you have submitted your attestation to us.…

  • Billing

    Sign up for EFT to receive payment faster, and have remittance advice mailed to you. Learn how.…

  • Update Your Information

    Update Your Information Changes If any of your practice information has changed such as TIN, practice location, change in ownership, etc., please fill out the following form and submit via facsimile to Attn: Provider Services Dept (541) 768-4513. Demographic Change form Additions If you are add…

  • InterCommunity Health Network CCO

    The InterCommunity Health Network Coordinated Care Organization's (IHN-CCO) partnership currently serves more than 50,000 Oregon Health Plan members. Visit our member website Transforming Health Care We are continually looking for ways to make health care work better in our communities. Read our pla…

  • Enroll in EFT or ERA

    Did you know that Samaritan Health Plans can send your payments using an electronic funds transfer (EFT) even if you still require a paper remittance advice? Review guidelines. To enroll in EFT or ERA, or to make a change to your current enrollment, complete the EFT/ERA Enrollment Form and fax it to…

  • Network Pharmacies

    Network pharmacies consist of pharmacies we have made arrangements with to provide prescription drugs to plan members. Provisions are in place for emergencies if a member is out of the service area. For information on Samaritan Choice Pharmacies, please visit the Choice member website. IHN-CCO Pha…

  • High-Risk Medications and Medicare Members

    Just like you, our members’ health and safety are our highest priority. We would like to work with you to avoid prescribing drugs considered high-risk for our members over the age of 65. High-risk medications are those identified by AGS Beers Criteria and by the Pharmacy Quality Alliance that tend t…

  • Support

    We view health care as a team effort, with you as our partner in improving the health of our members. To support collaboration we have developed a number of tools and resources for you.…

  • Terms of Use and Privacy Policy

    This Terms and Conditions of Use Agreement ("Agreement") is a legal agreement between you and Samaritan Health Plans, Inc. governing your use of this Website (the "site"). YOUR USE OF THIS SITE IS SUBJECT TO THE TERMS AND CONDITIONS OF THIS AGREEMENT. BY ACCESSING, USING AND/OR VIEWING OUR SITE, YOU…

  • Medication Exceptions and Redeterminations

    If your patient's medication is not listed, you can ask us to make a medication exception to our coverage rules if they are a member of one of our plans that offer prescription drug coverage.  Medication Exception Form If your patient was denied your request for coverage of (or payment for) a prescr…

  • IHN-CCO Formulary

    Search the IHN-CCO Formulary by medication name or type. Search results include: Any restrictions for the drug, such as prior authorization, quantity limits or step therapy requirements; The effective date of the formulary and the date it was last updated. Mobile device users should o…

  • Pharmacy

    View and search our plans' formularies. Our interactive formulary search tool allows you to search by medication or type.…

  • Samaritan Choice Formulary

    The search tool below allows searches by medication name or type. Search results include: The copay (amount) or coinsurance (percentage) that the member will be required to pay for the drug; Any restrictions for the drug, such as prior authorization, quantity limits or step therapy requirem…

  • Forms

    Find the form you need by selecting plan type.…

  • Case Management Services

    We offer support and assistance to members who are experiencing immediate and on-going medical conditions or injuries that may require complex, high-intensity, long-term and /or high utilization of services. Our case management team is composed of case management nurses, exceptional needs care coord…

  • Reporting Fraud, Waste and Abuse

    If you suspect that a provider, supplier or care facility has committed a wrongdoing, including ethical issues, potential conflicts of interest, potential non-compliance issues, potential fraud, waste or abuse allegations, etc., (see above for definitions of fraud, waste and abuse), we ask that you …

  • Claims Submission Options

    Even for claims billed under the First Choice Health or First Health networks, submit these claims directly to Samaritan Health Plans to ensure prompt payment.…

  • Reimbursement Guidelines

    We have guidelines available to help you with reimbursement for the following services: Adolescent Well Care Annual Preventive Exams for Medicare Patients Contraception Childhood Immunizations (Ages 0–18) Developmental Screenings Immunizations Preventive Care Services SBIRT Services Telemedicine S…

  • Alternative Payment Methodologies Forum

    The following keynote speakers each shared how they have achieved the 5-star designation: Sherlyn Dahl, Executive Director — Community Health Centers of Benton & Linn Counties Megan Van Vleet, Clinic Operations Manager — Samaritan Pediatrics and Samaritan Health Services Center for Heal…

  • Refer For Care

    You can search the following for in-network providers: First Choice Health Network includes providers in Oregon, Washington, Alaska, Idaho, Montana, North Dakota, South Dakota and Wyoming: Search First Choice First Health Network offers additional U.S. coverage outside of Oregon, Washington, Alaska,…

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