Oregon

Oregon Medicaid, Reimagined.

Oregon's home care Medicaid system comes with its challenges – manual MMIS uploads and monthly EVV emails. Paradigm steps in to ease the load. We're breaking the mold with cutting edge automation and streamlined Medicaid billing.

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How Paradigm Helps.

Billing

We manage the billing process end-to-end, aligning EVV and billing data for timely payments.

Enrollments

We help you access new payer lines, creating more income opportunities.

Eligibility

We monitor client eligibility and authorizations to ensure continuity of care and payments.

EVV Support

We optimize EVV and AMS configuration to ensure accurate Medicaid billing.

Training

We provide tools and education to help you grow your Medicaid census.
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Medicaid
in
Oregon
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Oregon boasts the best Medicaid rates in the country, a diverse range of waiver programs, and high client volume. The opportunity is unmistakable. With Paradigm, confidently navigate Medicaid, leaving the manual MMIS uploads and EVV challenges to us. Focus on what matters most: your growth in the Oregon home care market.

how evv works

Electronic Visit Verification

EVV and home care Medicaid billing in Oregon can be confusing; here’s what you need to know.

EVV

Providers have the flexibility to select their preferred Electronic Visit Verification (EVV) system.

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EVV Aggregator

The designated EVV aggregator in Oregon is eXPRS. Providers are required to submit their EVV data manually via email on a monthly basis.

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Billing Process

Providers must manually submit their Medicaid billing claims through the MMIS system. This process demands careful and precise data entry to ensure accuracy.

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Rates

According to the Oregon Health Authority (OHA), the current Medicaid rates for home care services in Oregon stand at $36.24. However, it's important to note that Managed Care Organizations (MCOs) may negotiate rates that differ from the OHA's standard fee schedule.

These negotiated rates are specified in the billing terms of individual payer contracts. Consequently, it's essential for home care providers to meticulously review all payer contracts

Payers

State Direct: Oregon Health Authority
Managed Care Organizations: There are a number of MCOs that cover home care in Oregon. Reach out to us, and we can help you identify them all.
Waiver Programs: Aged & Physically Disabled (APD) Waiver, Independent Choices Program (ICP), Consumer-Employed Provider Program, Spousal Day Program, Oregon K Plan (Community First Choice), State Plan Personal Care (SPPC) Program, Oregon Project Independence (OPI)

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