We provide comprehensive healthcare services to Hillsboro and surrounding communities.

Referrals & Pre-Authorizations

Certain Oregon Health Plan (OHP) services require referrals and/or prior-authorizations. 

As a provider, it is your responsibility to have an approved prior-authorization (if required) prior to providing the service to the member.
Dowload current list of services that require referral/pre-authorization (PDF) »

For a member’s referral or pre-authorization to be valid, he/she needs to have been evaluated by his/her THA-network PCP within the previous 12 months.

Referral or pre-authorization is not required for visits to a Full/Associate or Preferred THA Specialist, for office or outpatient procedures that are above-the-line on Oregon’s prioritized list with matched ICD and CPT codes, or for covered formulary medications.

Routine Referrals and Prior Authorizations

THA is allowed 14 calendar days to make a pre-determination regarding referral and pre-authorization requests.  THA strives to complete requests within the first 7 days.  Please do not call to check status within the first 7 days.

Urgent/Expedited Referrals and Prior Authorizations

THA considers URGENT to mean:

Providers may submit requests for “urgent” or “expedited” referrals or pre-authorizations  by checking the “Expedite” box on any THA referral or prior authorization form and submitting the form to THA via fax or phone. THA Medical Management staff will make an expedited referral determination within 72 hours of receipt.

Referrals and Pre-Authorizations for After-Hours and Weekend Services