Get the free EOCCO Out of Network (OON) provider behavioral health authorization form (updated 3/23)
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Out of Network (ON) Provider
Behavioral Health Authorization Form
Send Authorization Requests via: Fax: 5412961036 or SECURE Email: um@gobhi.org
If you have behavioral health authorization form questions,
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How to fill out eocco out of network
How to fill out eocco out of network
01
Contact your insurance provider to inquire about out-of-network coverage with Eocco.
02
Obtain a referral or pre-authorization if required.
03
Keep track of all medical expenses and submit claims to Eocco for reimbursement.
04
Follow up with Eocco on the status of your claims and payments.
Who needs eocco out of network?
01
Individuals who prefer to see healthcare providers who are not in Eocco's network.
02
People who require specialized or out-of-network medical services that are not available in-network.
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What is eocco out of network?
EOCCO out of network refers to providers or healthcare facilities that do not have a contract with Eastern Oregon Coordinated Care Organization (EOCCO) for providing healthcare services or treatments.
Who is required to file eocco out of network?
Healthcare providers who provide services to EOCCO members but do not have a contract with EOCCO are required to file EOCCO out of network claims.
How to fill out eocco out of network?
Providers must submit a completed EOCCO out of network claim form along with all necessary supporting documentation to the EOCCO claims department.
What is the purpose of eocco out of network?
The purpose of EOCCO out of network claims is to reimburse healthcare providers who do not have a contract with EOCCO for the services provided to EOCCO members.
What information must be reported on eocco out of network?
Providers must report detailed information about the services provided, including dates of service, diagnosis codes, procedure codes, and charges.
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