Check out these helpful member resources
We want you to have great dental health. We also want you to make the most of your dental plan. Check out these resources. You can view them here, or download and print them.
Your Member Handbook
Your Member Handbook can be found on your coordinated care organization’s (CCO) website. Click on the link below to access your Member Handbook. Look at your ID card to identify your CCO.
- Columbia Pacific CCO
- Eastern Oregon CCO
- Health Share of Oregon
- IHN CCO
- Jackson Care Connect
- Trillium Community Health Plan
- PacificSource Community Solutions-Central Oregon
- PacificSource Community Solution-Lane
- PacificSource Community Solutions-Marion Polk
- PacificSource Community Solution Columbia Gorge
PHI Disclosure Forms
- PHI Disclosure Form (English)
- Autorización para la divulgación de información de médica protegida (PHI) (Spanish)
- Разрешение на раскрытие защищенной медицинской информации (PHI) (Russian)
- 受保护的健康信息 (PHI) 披露授权 (Chinese)
- Giấy cho phép tiết lộ thông tin sức khỏe được bảo vệ (PHI) (Vietnamese)
- Oggolaanshaha Shaacinta Macluumaadka Caafimaadka ilaashan (PHI) (Somali)
- (PHI) المحمية المعلومات الصحية تصريح باإلفصاح عن (Arabic)
Interpreter services
Help for your dental health
Learn more about dental health with this helpful info.
English:
Spanish:
Russian:
Chinese:
Vietnamese:
Somali:
Arabic:
Appeals and grievances
Use the following to file an appeal or grievance:
Member appeal form (English)
Formulario de apelación para miembros (Spanish)
форма апелляции участника (Russian)
会员申诉表 (Chinese)
mẫu đơn khiếu nại thành viên (Vietnamese)
foomka racfaanka xubinta (Somali)
قسم نظم الرعاية الصحية (Arabic)
Member grievance form (English)
Formulario de quejas para miembros(Spanish)
Форма заявки участника(Russian)
会员申诉表 (Chinese)
Mẫu gửi thành viên (Vietnamese)
Foomka soo gudbinta xubinta (Somali)
نموذج تظلمات الأعضاء(Arabic)
Frequently asked questions
Need more info? Take a look at our FAQs.
Contact us
We’re here for you, and we want to help.