Provider updates

The Oregon Health Plan (OHP) offers non-emergency medical transportation (NEMT) resources to ensure members have access to covered health care services. TransLink serves members enrolled with Jackson Care Connect (JCC) in Jackson County.

What you need to know

TransLink will, at times, request your assistance with verifying appointments for JCC members who use the TransLink brokerage for NEMT services. TransLink may ask health care providers about protected health information (PHI) for members using the service, including:

• Whether the member has a scheduled appointment
• Whether the member has attended an appointment
• Specific information about the service the member will get at the appointment. This is to verify that the appointment is for a covered service.
• If the appointment is outside the member’s local area, whether the member can get the service locally.
• Whether the member is physically and mentally able to use certain types of transportation.

How does this impact members?

This information is necessary to confirm eligibility and provide covered services, while maintaining compliance with HIPAA regulations. If TransLink is unable to verify information to confirm appointments and covered services, this may result in denial of members’ requested trips.

Ensure you are set up for success

If your office requires a signed Release of Information (ROI) to share patient details, please ensure the appropriate paperwork is on file. Proper verification is critical for avoiding transportation request denials and enabling members to attend their appointments.

More information on TransLink

For more details about TransLink, visit https://rvtd.org/accessible-transportation/translink/.