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2022 Summary of Benefits & Coverage - EPO Silver 6850 Tier 3 Review what this plan covers and what you pay for covered services.
Understand the No Surprises Act Understand how the No Surprises Act impacts the maintenance of provider directories and the need to keep your provider information accurate and updated.
Wireless Gastrointestinal Monitoring System Policy Understand the criteria required for coverage of the Wireless Gastrointestinal Monitoring System.
2023 Summary of Benefits & Coverage - EPO Platinum 500 Tier 1 Review what this plan covers and what you pay for covered services.
Record Request Form Use this form if you are someone other than the member (or their legal representative) and need to request a copy of our member’s record for which the member’s authorization is required.
Reimbursement Guidelines - Childhood Immunizations Use these guidelines when coding, billing and documenting childhood immunizations.
Notice of Privacy Practices - Samaritan Choice & Employee Groups Learn how we use and share your health information and how you can get a copy.
Interoperability Payer Data Exchange Form - SPA Use this form to allow your health plan to share your health information with another payer.
Fraud, Waste & Abuse Program - Samaritan Health Plans Understand the process for reporting suspected or confirmed fraud, waste or abuse.
Medicaid Provider Validation Application Complete this form and provide supporting documentation to be validated prior to reimbursement for Medicaid claims.
Health Alert for Patients & Visitors: Novel Coronavirus Health alert for patients and visitors regarding COVID-19 and how to protect yourself.
2022 Pharmacy Directory - Samaritan Choice Learn which pharmacies are in-network for Samaritan Choice.
Surescripts Prior Authorization Portal Guide Understand how to access Surescripts site for prior authorizations.
2022 Renewal Change Form - Large Group Complete this form to renew or change your health plan coverage.
2022 Plan Summary - Oregon Small Employer Group Gold 4000: 20% 6500 See an easy to read overview of your covered benefits.
Notice of Privacy Practices - InterCommunity Health Network CCO Learn how we use and share your health information and how you can get a copy.
2023 Prior Authorization Criteria - Premier & Premier Plus Plans Understand the criteria used for medications that require prior authorization.
2022 Evidence of Coverage - Samaritan Advantage Premier Plan See the complete details and documentation about this plan, including what is covered and what you pay.
2022 Plan Summary - Oregon Small Employer Group Silver 5200: 30% 8700 See an easy to read overview of your covered benefits.
2023 Summary of Benefits & Coverage - EPO Gold 3150 Tier 1 Review what this plan covers and what you pay for covered services.
2022 Plan Summary - Oregon Small Employer Group Gold 2500: 30% 6200 See an easy to read overview of your covered benefits.
2022 Summary of Benefits & Coverage - EPO Silver 2800 HDHP Review what this plan covers and what you pay for covered services.
Glossary of Insurance Terms Refer to this glossary to understand commonly used insurance terms.
2023 Schedule of Benefits - Choice Wellness Plan Review what this plan covers and how much you pay for covered services.