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Request Participation Within Our Network

As a Trillium Community Health Plan provider, you can rely on:

  • A comprehensive approach to care for your patients through disease management programs, healthy behavior incentives and 24-hour toll-free access to bilingual registered nurses
  • Initial and ongoing provider education through orientations, office visits, training and updates
  • A dedicated claims team to ensure prompt payment
  • Minimal referral requirements and limited prior authorizations
  • A dedicated provider engagement team to keep you informed and maintain support in person, by email or by phone
  • The ability to check member eligibility, authorization and claims status online;
    healthcare collateral for your patients (e.g., information about our benefits and services), and educational displays for your office
Form Selection

Credentialing Requirements/Forms for Contracted Practitioners

Medical Practitioners & Licensed Behavioral Health Providers

Please complete the New Practitioner Enrollment Packet (PDF) and submit along with all other required documents listed below to ORProviderExperience@trilliumchp.com

  • Oregon Licensure
  • DEA (if applicable)*
  • Certificate of Professional Liability Insurance* 
  • Hospital Admit Plan

* Action Required: If your practitioners are registered with CAQH, documents noted above are required to be uploaded in CAQH and current. Please authorize Centene Corp to access application in CAQH.

Pre-Licensed Behavioral Health Practitioners

Please complete the Trillium BH Pre-Licensed Enrollment Packet (PDF) and submit to: ORProviderExperience@trilliumchp.com

Facilities

Credentialing Requirements/Forms, for new facility enrollment:

* Please send all documents and/or roster to ORProviderExperience@trilliumchp.com

Roster

To ensure that our system pays claims and is loaded with the correct practitioner information, please submit your roster every quarter:

  • Download a copy of the Centene Roster (Excel)
  • Fill out the required fields and email the roster to ORProviderExperience@trilliumchp.com
  • If your office has its own roster with the same required fields, you can send it to our Provider Operations team instead of the Centene Roster.  

Network Participation Steps

  • Please complete one of the following participation forms: Trillium Provider Interest Form or Trillium Facility and Ancillary Provider Interest Form. Please note: You will be required to fill out the form and attach all relevant credentialing documents upon form submission. The list of required documents is at the bottom of each form. 
  • PLEASE NOTE: IF POSSIBLE CREATE A ZIPPED FILE OF ALL REQUIRED INFORMATION FOR EASE OF SUBMISSION. Your submission will be reviewed and a response will be provided within 60 days of receipt. 
  • While we evaluate, you may still care for Trillium Community Health Plan members by obtaining a prior authorization (PA). PA APPROVAL IS REQUIRED FOR ALL NON-PARTICIPATING PROVIDERS SERVICES. You may submit a request using our PA Form.
  • You may also fax the completed form to: 866-703-0958 (Standard Medicaid Requests).
  • Once our Utilization Management (UM) team has reviewed your request, a decision letter will be faxed to the number you provide on the form.
  • If you need assistance with the PA process prior to providing services to a Trillium member as a non-participating provider or have other questions, please contact Trillium Provider Services at 1-877-600-5472. 
  • We appreciate your commitment to serving our members and thank you again for your interest in Trillium Community Health Plan.
  • Please Note: If you are a Routine Vision Services provider, please send those inquiries to Envolve Network Management at EBONM@EnvolveHealth.com.

All Medical and Behavioral Health Network Participation Requests

Trillium Provider Interest Form

  • All Medical Specialties
  • Solo Practitioners
  • Advanced Practice Practitioners
  • Medical Groups 
  • Multi-Specialty Medical Groups
  • Behavioral Heatlh Providers

Facility and Ancillary Network Participation Requests

Trillium Facility and Ancillary Provider Interest Form

  • Ambulatory surgery centers (ASCs)
  • Dialysis facilities
  • Durable medical equipment (DME)
  • Home health
  • Home Infusion
  • Hospice
  • Hospital
  • Laboratory
  • Long term acute care (LCTA)
  • Orthotics and prosthetics (O&P)
  • Ostomy and medical supplies
  • Radiology/MRI/PET
  • Skilled nursing facilities (SNF)
  • Sleep study centers