Together we can support a healthy community
YCCO collaborates with a network of medical, dental and behavioral health specialists as well as social support partners. We all work together for the good of our patients and the health of our community.
With a healthy early start in life and the services we provide, our members can overcome many barriers to health. We work with community, government and social agencies to address issues like homelessness, hunger and addictions. And we work with providers like you to share electronic medical records and manage measurable outcomes for programs which focus on specific community issues.
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To help you deliver the best care possible for our members, take advantage of the resources below!
Provider information is available 24/7 through the Provider Portal (CIM)
The Portal makes it convenient to access patient eligibility, review claims/payment information, submit a claim, check on the status of a referral, or submit one and has information regarding prior authorizations.
Please note: all prior authorizations are to be submitted through the portal.
Need access?
If you are a new provider who needs access to the portal, or if you are an established provider with portal questions, please submit an online request below or call Customer Service at 855-722-8205.
Submitting a claim is easy
Submit electronically using the provider portal or by logging in directly to CIM. If you need assistance on submitting a claim submit call Customer Service at 855-722-8205.
Claims can also be mailed to:
Yamhill Community Care
PO Box 5490
Salem, OR 97304
To receive electronic claims payments and/or remittances please register with Payspan. You will need a Registration Code and PIN in order to register. Please contact PaySpan Provider Services at 877-331-7154, Option 1 for assistance.
Clinical guidelines keep you current
These guidelines, based on best practices, support the excellent care of our OHP members. These resources can help identify health and lifestyle issues. They will also help providers and patients learn and use the best treatment methods.
Physical health
Physical health guidelines can help providers choose the best treatment for medical conditions.
Dental health
Yamhill Community Care contracts with Capitol Dental Care for member dental care. Guidelines have been adopted.
Behavioral health
These behavioral health guidelines identify different levels of care and corresponding treatment for OHP members.
Quick Reference Guidelines
Opiate Prescribing
Adopted from Oregon Pain Guidance, these guidelines cover treatment of chronic pain among OHP members.
Prescription Drug Monitoring Program
The Oregon Prescription Drug Monitoring Program (PDMP) is a tool to help healthcare providers and pharmacists provide patients with better care in managing their prescriptions. It contains information provided by Oregon-licensed retail pharmacies.
Vaccinations
These guidelines aim to increase community-wide childhood and adolescent vaccination rates in Yamhill County.
Patient-Centered Primary Care Home Program (PCPCH)
Any health care practice that provides comprehensive primary care and meets the key standards can become a recognized Patient-Centered Primary Care Home, including:
- Physical health providers
- Behavioral, addictions and mental health care providers with integrated primary care services
- Solo practitioners
- Group practices
- Community mental health centers with integrated primary care services
- Rural health clinics
- Federally qualified health centers
- School-based health centers
If you are interested in learning more about PCPCH recognition, please visit the page linked below.
Value-Based Payment
Value-based payment (VBP) is one of the Oregon Health Authority’s (OHA’s) primary strategies for achieving the triple aim of better health, better care and lower costs for all Oregonians.
To learn more about VBP please visit the OHA website page linked below.
OHA Value Base Care website page
Metrics and Performance
Since July 2020, YCCO has used PhTech’s AYIN Insights platform to offer our providers access to real-term updates on incentive metrics performance. It is fully integrated as a feature within CIM, and t’s key features include graphical visualizations of metrics performance and the ability to review and export gap lists of members who apply to each metric. Access to this platform is available at no cost to any YCCO provider.
- Providers interested in gaining access to this platform should contact YCCO at providerrelations@yamhillcco.org with the following information:
- Full Name
- Email Address and Phone Number
- Clinic Name and address
- Clinic NPI and TIN
- Job Title
- A provider-focused tutorial of basic Insights functions can be found here.
- Current Insights users with questions or feedback about the platform should reach out direct to YCCO at Providerrelations@yamhillcco.org
The Collective Platform
EDIE: EDIE technology provides real time alerts that allow emergency department clinicians to identify individuals who are frequent utilizers of the emergency department or who have active care guidelines or security events noted in the Collective platform. EDIE also provides alerts on individuals who have triggered the Prescription Drug Monitoring Program (PDMP) criteria. All hospitals in Oregon have adopted EDIE and are receiving notifications.
Collective platform: The Collective platform is a complementary product to EDIE that enables hospital event information (ED and inpatient admissions and discharges) to be sent to health plans, CCOs, primary care, behavioral health, post-acute and specialty providers for specified member or patient populations. This information provides the ability to rapidly identify at risk patients or members and support them in getting the right care through improved care coordination.
For information on how to get access to The Collective Platform please e-mail providerrelations@yamhillcco.org
Report fraud, waste and abuse
Medicaid fraud is against the law and should be reported. Fraud covers providers charging for services that weren’t provided or patients using another person’s ID to get OHP benefits. You can report fraud, waste or abuse of Medicaid benefits electronically or via phone or mail.
Report provider fraud:
Medicaid Fraud Control Unit (MFCU)
Oregon Department of Justice
100 SW Market Street
Portland, OR 97201
Phone: 971-673-1880
Fax: 971-673-1890
OHA Program Integrity Audit Unit (PIAU)
3406 Cherry Avenue NE
Salem, OR 97303-4924
Phone: 888-372-8301
Fax: 503-373-1525 ATTN: HOTLINE
Report member fraud:
DHS/OHA Fraud Investigation
P.O. Box 14150
Salem, OR 97309
Phone: 1-888-FRAUD01 (1-888-372-8301)
Fax: 503-373-1525 ATTN: HOTLINE
YCCO Compliance & Ethics Hotline:
Providers may also report potential fraud, waste and abuse to YCCO directly. YCCO has an anonymous Compliance & Ethics Hotline available 24/7 in which anyone may leave a voicemail message. This voice mailbox is monitored daily. Call the toll-free number (844) 989-2845 to make a complaint.
Do you need to make an anonymous report for a violation stated in the Yamhill Community Care Code of Conduct? You can file your anonymous report through Ethics Point by clicking here.
Contracting with YCCO
If you would like to become an in-network provider with YCCO please submit your request electronically at the link below or by emailing providerrelations@yamhillcco.org. Please include in your request your name (if different than the provider name), provider name with licensure, NPI, tax ID, an email address and telephone number you can be reached.