Tuality Healthcare Plans
Oregon Health PlanOregon Health Plan
OHP Plan Documents
Notice of Privacy Practices
Member Handbook (English)
Member Handbook (Spanish)
Provider Manual
Tuality Health Alliance Policies
- 5-1 Case Management Program
- 5-2 PO Case Management Referral
- 5-3 PO Mbr Referral Pre-Authorization
- 5-4 PO Clinical Criteria for UM Decisions
- 5-5 Communication Services
- 5-6 Appropriate Professionals
- 5-7 Attachment Timeliness Requirements for Review Decisions
- 5-7 PO Timeliness of Referrals
- 5-8 PO Clinical Information
- 5-9 PO Denials
- 5-10 PO DMAP Appeals
- 5-10 PR DMAP Appeals
- 5-11 PO New Technology
- 5-12 PO Ensuring Appropriate Utilization
- 5-13 Hospital Acquired Conditions
- 5-14 PO Concurrent Review
- 5-15 PO Self Referral Care
- 5-16 PO SNF
- 5-17 PO DCP
- 5-18 PO Second Opinion
- 10-1 PO Overview of Credential Policies
- 10-2 PO Initial Credentialing Verification
- 10-3 PO Application & Attestation
- 10-4 PO Initial Sanction Information
- 10-5 PO Site Reviews
- 10-6 PO Recredentialing Verification
- 10-7 PO Ongoing Monitoring
- 10-8 PO Notifying Authorities & Practitioner Appeal Rights
- 10-9 PO Delegation of Credentialing
- 10-10 PO Professional Misconduct
- 10-11 PO Restriction, Suspension, Termination of Physician
- 10-12 Level 1 Credentialing
- 10-13 Organizational Provider Credentialing
- 10-14 Ancillary Provider Credentialing
- 10-15 PO Medical Director - Role & Responsibilities