To: All SSP Staff
From: Sandy Dugan, Administrator, CW/SSP Field Services
Date: March 28, 2014
Subject: Medical Updates: Information on the OHP Redetermination Letter & Other Hot Topics
All of you have done a great job transitioning to our new processes for medical and keeping up with the adjustments necessary for fine-tuning our activities. Your attention to the medical changes continues to be needed and is much appreciated.
Below are the latest updates that I encourage you to cover during huddles and staff meetings. I also am asking that you take some time to discuss our current role in medical. Although our role has shifted, we do have an important part to play in making medical referrals and we are expected to direct customers to the right place for help. We’re working on a short guide with tips on how to respond to questions. In the meantime, please remember that the Quick Reference Guide “Customer Assistance for OHP Members” can help us direct customer questions.
Medical Updates:
Oregon Health Plan Customer Service Talking Points: Oregon Health Authority (OHA) has put together the attached talking points to assist staff who are providing medical-related customer service.
Updating and transferring medical cases in SSP branches: There are more than 30,000 medical cases remaining in SSP branches. Your branch will receive a list of cases by mid-April for you to update based on set guidelines and then transfer to the appropriate location (OHA or APD/AAA). Please make this work a priority, as it will help minimize confusion for OHP customers who are being redirected from the OHP Call Center to a local branch because their medical case in UCMS still resides within a branch.
New OHP 7210: The Family Application for Health Insurance was recently revised. Click here to review the transmittal on how to respond to the changes. Follow the regular process to order the new OHP 7210.
MMIS Cheat Sheet: See the attached tool, created to help you navigate the system and better understand the information you see in MMIS.
Premature mailing of OHP Redetermination Notices: OHA prematurely mailed OHP Redetermination Notices to 21,000 individuals. The notice says that an application has already been mailed. It has not been mailed. If you get questions from customers, you can use the response below:
Standard response: We apologize for any inconvenience but the Oregon Health Authority sent that letter too early. You are covered through the end of April. You do not need to do anything at this time. OHA will send you a new letter with additional information in the coming weeks. Again, your Oregon Health Plan benefits are still in effect through the end of April.
A copy of the notice that was prematurely sent to the 21,000 individuals and an FAQ with additional information that may help you answer customer questions are attached.
Note: Please check MMIS to make sure the customer is covered through April before responding to any questions.
Referring Third Party Liability (TPL) customers to the Health Insurance Group (HIG): As a reminder, SSP offices will keep a supply of 415H forms and should provide a form to customers when they report TPL. SSP staff should FAX the completed 415H directly to HIG at 503-378-6233 on the customer’s behalf unless the customer chooses to submit the form another way.
When you discuss our new role in medical with your teams, please be sure to share with us any questions you need help answering. The questions you have are likely being asked in other branches, too, and we would like to continue providing answers and sharing them across the state for consistency.
You can contact Courtney Hill with questions at or by phone at (503) 945-6577.We look forward to hearing from you and thank you again for your efforts.
Thank you,
Sandra Dugan