Skip to Main Content

Provider Digest | Volume 175

Date: 06/18/25

Behavioral Health Providers: Transition to the Availity Essentials Portal for Enhanced Self-Service Options 

Starting August 20, 2025, the MHN provider portal at MHN.com and the email-based claims submissions on the Research and Review web page will no longer be available. To ensure seamless operations, if you haven’t already done so, we encourage Trillium, Health Net, and Wellcare providers to transition to the Availity Essentials portal for your secure online self-service needs.

To learn more about the benefits of Availity Essentials and how to get started, review the article in our January 22, 2024 Provider Digest.

Continuing access with Trillium, Health Net, and Wellcare’s provider portal
While we recommend transitioning to Availity Essentials for more robust self-service options, you can still access the existing legacy Trillium, Health Net, and Wellcare provider portal while you prepare to move to Availity.

Prior authorization submissions via Availity Essentials
Effective July 1, 2025, for initial prior authorization request of all facility-based behavioral health services for Trillium, Health Net, and Wellcare members, we recommend using the Availity Essentials portal for real-time and faster processing. Concurrent reviews will be continued directly with the assigned Utilization Review Clinician.

Online submissions are highly encouraged, but requests can still be submitted via fax at 855-663-2244 or call 844-966-0298 for assistance.

For transcranial magnetic stimulation (TMS), ABA, or neuropsychological testing, please continue submitting via fax at:

  • TMS: 855-661-0077
  • ABA: 855-427-4798
  • Neuropsychological testing: 855-703-3268

Additional information

        ______________________________________________________

        IRCO No-Cost Vaccination Clinic and Resource Fair

        The Immigrant and Refugee Community Organization (IRCO) is offering a free vaccination clinic in Beaverton for school-aged children and adults. No appointments are required. Oregon Health Plan enrollment and other community resources will also be available at the vaccination clinics.

        IRCO No-Cost Vaccination Clinic and Resource Fair 

        Please share this information with your patients who may want to attend.

            ______________________________________________________

            Trillium Behavioral Health Provider Credentialing Update for July 1, 2025

            What is changing
            As of July 1, 2025, Trillium Community Health Plan (Trillium) will change our behavioral health (BH) provider credentialing process for unlicensed practitioners. This change is applicable for all unlicensed practitioners who are employed with BH providers, regardless of whether they hold a Certificate of Approval (COA) with Oregon Health Authority (OHA) for BH services or not. 

            As a CCO and partner with our BH provider network, Trillium values a whole-person approach to overall wellness and access to healthcare services for our members. That includes our responsibility as a CCO to thoroughly vet practitioners employed by our provider network to ensure high quality, effective and safe BH treatment services.   

            • Currently, our process for credentialing unlicensed practitioners is not aligned with our standard process for licensed practitioners. This change will create a streamlined approach with a similar process for both licensed and unlicensed practitioners. 
            • Trillium will require unlicensed practitioners to submit an Oregon Practitioner Credentialing Application (OPCA) for all new credentialing requests and for recredentialing.

            What is remaining the same
            There is no change to the existing credentialing or recredentialing process for the following BH practitioner types:

            • BH practitioners with an active license issued by Oregon state clinical board to practice independently. 
            • BH practitioners who work with a provider who is currently approved for delegated credentialing through Trillium. 

            Where to send questions or updates to your Trillium BH roster

            ______________________________________________________

            Evolent Prior-Authorization Submission and Status Monitoring

            The Evolent program, formerly National Imaging Associates (NIA) and New Century Health (NCH), includes management of non-emergent, high-tech, outpatient radiology services and non-emergent outpatient and surgical radiation oncology services through prior authorization and contractual relationships with free-standing facilities. This is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services.

            Complex imaging, CT, PET, MRA, MRI, musculoskeletal, and high-tech radiology procedures require prior authorization through Evolent. Evolent provider portals can be accessed here at evolent.com/provider-portal.

            For more details about how to submit requests, as well as online resources and contact information, please view this notice (PDF). 

            ______________________________________________________

            Model of Care Training Required for Dual Eligible Special Needs Plan Providers

            ​The Centers for Medicare & Medicaid Services (CMS) require health plans to provide annual education and training regarding our Special Needs Plan (SNP) Model of Care to providers who treat our SNP members. This applies to our Dual Eligible Special Needs Plan (D-SNP) members, who are eligible for both Medicare and Medicaid, and our Chronic Condition Special Needs Plan (C-SNP) members.

            As stated in our provider manual, all providers who treat our SNP members, regardless of network participation status, must complete Model of Care (MOC) training annually by Dec. 31. The training is designed to help you better understand our approach to the delivery of care for SNP members.

            How to Access Training
            The SNP MOC training is available for download and self-study on the Trillium Model of Care Training webpage and Health Net Model of Care Training webpage. 

            We appreciate the quality care you provide to our members and your support of our efforts to meet CMS regulations.

            For additional information on how to work with our health plan to manage SNP members, please visit our Provider Resources webpage. The Provider Resources page includes links to provider manuals, Clinical Practice Guidelines, and more.

            If you have any questions, please contact your assigned Provider Engagement Representative​:

            ______________________________________________________