Frequently Asked Questions

 

PrimeCare’s membership area includes Jackson County and Josephine County, Oregon.
By teaming up with hundreds of local providers, you’ll be part of our collective negotiations when it comes to payer contracts. With a history of skillfully negotiating contracts, we are able to attract health care companies who want to work with a large group of physicians. As a member of PrimeCare, you can be assured you’re receiving the highest possible insurance reimbursement.
Yes. Many payers require provider credentialing to receive in-network reimbursement. It’s also critical for patient safety and risk mitigation. PrimeCare ensures every provider interacting with a patient has the qualifications to do so.
PrimeCare provides credentialing services to our members through our contracts with Medicare Advantage Plans, Medicaid (OHP), and several commercial health plans. Providers can submit a single credentialing application, then receive peer review and verifications that meet the National Committee for Quality Assurance (NCQA) standards.
Primecare makes it easier to care for your patients based on value, rather than the number of procedures or visits. This enhances overall patient wellness, and opens the door for shared savings among PrimeCare members.
The average turnaround time is 45 days from receipt of your complete application. Our credentialing coordinator will work with you on any missing elements to ensure a streamlined process. PrimeCare’s Credentialing Committee meets monthly to review applications and approve new members.
We welcome applications of providers who practice locally and meet the following criteria:

  • Licensure as an MD, DO, DPM, PA, NP, CNM, CRNA
  • Admitting privileges at a hospital located in the PrimeCare service area
  • Agreed upon call-share with PrimeCare members of the same specialty 24/7
  • Maintain appropriate malpractice insurance coverage of $1 million per incident, $3 million aggregate

    • Copy of Oregon DEA certificate or a prescription plan
    • Copy of current Oregon state license
    • Proof of current malpractice insurance
    • If you do not yet hold admitting privileges at an area hospital, you will need to provide documentation of your admit plan
    • Medicare Provider Identification Number
    • OMAP/Medicaid Provider Identification Number

Oregon Credentialing Application PDF

Need to locate a PrimeCare provider?

Use this directory to search our membership by physician, clinic, or specialty.

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