Network
- What are the medical provider networks for OEBB members?
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Connexus is the primary network, and additional networks are available to members who live outside the primary service area.
Active employees and their dependents in Oregon, Southwest Washington and the border counties of Idaho who have selected a Moda plan use the Connexus Network.
Members who reside outside the state of Oregon use the following networks:
- What are the dental provider networks for OEBB members?
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Active employees, retirees and their dependents enrolled in OEBB plans 1, 5, and 6 use the Delta Dental Premier Network. Active employees, retirees and their dependents enrolled in OEBB's Exclusive PPO Incentive Plan and Exclusive PPO plan use the Delta Dental PPO network. If you are on an Exclusive PPO Incentive Plan or Exclusive PPO plan and seek care from a provider that is not part of the Delta Dental PPO network, services will not be covered. Both the Delta Dental Premier and Delta Dental PPO networks include access to the Delta Dental Provider Network nationwide.
- How can I find out if my medical provider is in or out of network?
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OEBB members have access to the Connexus network. Members who are outside the Connexus service area may have a different network depending on where they reside (see question 1 above). You can locate providers in your network by using our online provider directory, Find Care.
- If a specific clinic is not listed on the Moda Health website, how can I find out if my provider is in-network?
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You can search for a provider by name, specialty, ZIP code or city in which the provider is located.
It is easiest to search by the provider's last name or ZIP code because providers with multiple specialties may not be listed under all of their specialties.
Moda 360 Health Navigators are also available to help you locate in-network providers.
- Can I nominate a provider to participate in the network?
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The Connexus Network may be accepting new providers based on the area and other factors.
New providers need to meet requirements for credentialing approval, state and federal regulations, network needs, and other factors.
Here's how you can nominate a provider:
- Go to our OEBB provider networks page.
- Download and complete the medical provider nomination request form.
- Return the completed form to your provider's office and let them know you would like them to initiate a network participation request with Moda.
If the network is accepting new providers in the area, your provider's application will be reviewed and a Moda Health Contract Negotiator will contact them to start the contracting process.
Please note: a provider might reach out for information but ultimately choose not to contract for a variety of reasons. A nomination or a request for a contract alone does not guarantee that a provider will be in-network.
For the most up-to-date information on provider network participation, please visit our Find Care provider directory.
- If a provider is added to the network after I receive services, will Moda Health reprocess the claim to pay the in-network level?
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No. The provider will be paid the in-network rate only after being added to the network.
- What is my pharmacy network?
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OEBB members use a network called the ArrayRx Core network. This network excludes CVS pharmacies.
You can find in-network pharmacies by choosing "ArrayRx Core Network" from the Networks drop-down box in Find Care. You can also call your Moda 360 Health Navigator team at 866-923-0411.
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