Your Member Handbook by Chapter

Quick Start

Table of Contents
Tells you where you can find important information in your handbook.

Important Telephone Numbers and Contact Information
Gives you important contact information for PacificSource Community Solutions, Quit for Life tobacco program, and who to contact at The Oregon Health Plan (OHP) if you have questions.

Benefits Chart

Getting Care When You Need It
Tells you about your Primary Care Provider (PCP), how to get regular checkups and what to do when you get sick. It explains what to do if you need to see a specialist or have an emergency.

Our Community Advisory Council (CAC)
Tells you about our CAC, members, and explains how you can get involved.

Your Provider Directory
Tells you about the Directory and how to use it to find doctors and other providers.

If You Are Pregnant or Have a Newborn
Explains what to do when you know you are pregnant, services that are covered and who to call.

Physical Health Services and Benefits

Specialist Care and Referrals
Explains when you may need to get a referral to see a specialist.

Transportation Services

Behavioral Health Services
Explains behavioral health, the providers that are available on your plan, and what to do if you want to change your provider.

Dental Health Services
Tells you about dental providers and how to get care.

Medications

Billing Information
Explains when a provider can send you a bill and what to do if you have received a bill by mistake.

Other Things You Should Know
Important information about how to change your contact information, disenroll or change your plan.

Complaints and Appeals
Tells you what to do if you are having problems as a member of our plan. Explains what to do if you have a complaint. Explains the appeals process and what we will cover while you are waiting for an appeal or hearing decision

Member Rights and Responsibilities
Explains the rights and responsibilities you have as a member of our plan and how to contact PacificSource.

Your Health Records are Private
Tells you how Personal Health Information (PHI) about you may be used and shared. Explains your rights to this information.

Nondiscrimination Statement