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Each Moda Health medical plan and Delta Dental Plan of Oregon plan comes with a provider network. Each medical network is a group of licensed health professionals, clinics, pharmacies, labs and hospitals located in a certain area. These providers offer quality care and services to Moda Health members at an agreed-upon cost. Each dental network includes network dentists who accept the Delta Dental contracted fee so there will be no additional balance billing.

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  • Choosing the right network. Moda Health Alaska offers two networks: the Moda Health Alaska Select network and the ODS+Providence Alaska network. In each network, members are welcome to see any licensed provider at the in-network benefit level; however their benefits will go further when they choose to see a contracted provider.
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  • Complete and submit our new provider network participation request form. Please note that it may take up to 60 days for us to respond. We'll review your application and let you know if the panel is open in your area. If so, you are eligible to be a participating provider. We'll contact you to let you know how to continue with the process.

View our networks:

In-network care offers better value

Members get a better benefit and can save money by seeing in-network providers. These providers offer quality care and services to our members at an agreed-upon cost.

Care from out-of-network providers may also be subject to 'balance billing' ‐ the difference between what the plan allows or reimburses and the providers' billed charges. In-network providers don't do this.

Complete and submit our new provider network participation request form. Please note that it may take up to 60 days for us to respond. We'll review your application and let you know if the panel is open in your area. If so, you are eligible to be a participating provider. We'll contact you to let you know how to continue with the process.

Is a provider in-network?

Members can find out by visiting modahealth.com and using Find Care. They choose a network and look for a doctor, dentist or facility nearby.

Questions?

We're here to help. Contact our Sales and Account Services team for friendly support.

Here are the medical provider networks for our Oregon small and large group members. Members save money by seeing in-network providers. Check medical plan summaries to see which medical network each small group plan includes.

Connexus Network

When clients want our broadest selection of providers across Oregon, Connexus Network has them covered. Clients located anywhere in Oregon can choose a plan with this network. Members can see in-network providers in all counties in Oregon and some areas in Washington and Idaho.

Coordinated Care Model (CCM) plans

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Our CCM plans, powered by the Synergy network, offer patient-centered care with a team-based approach. The plans connect a primary care provider with the rest of a member's care team (other providers, specialists, etc.) to bring members the best treatments. By choosing a CCM plan, members will enjoy a team-based approach to healthcare, coordinated care across the healthcare system for better health outcomes, and a dedicated Primary Care Provider (PCP) that coordinates care. The CCM plan is the best option for members looking for partners to help them on their healthcare journey. This is also the ideal option for members who are managing an existing condition because of its laser focus on wellness, prevention and improving their quality of life.

Synergy Network

Groups located in Oregon can choose a plan with the Synergy network. The Synergy Network covers every county in Oregon. Members living or working in these areas can access care through the PCP they select.

Hospitals and health systems affiliated with the Synergy Network include:

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  • Adventist Health (OHSU partner)
  • Asante
  • Bay Area Hospital
  • Blue Mountain Hospital District
  • CHI St.Anthony Hospital
  • Columbia Memorial Hospital
  • Curry Health District
  • Good Shepherd
  • Grand Ronde Hospital
  • Harney District Hospital
  • Kadlec Regional Medical Center
  • Lake Health District
  • Legacy Health
  • Lower Umpqua Hospital
  • Mercy Medical Center
  • Mid Columbia Medical Center
  • Morrow County Health District
  • Oregon Health & Science University (OHSU)
  • PeaceHealth
  • Salem Clinic
  • Salem Health
  • Samaritan Health Services
  • Santiam Memorial Hospital
  • Sky Lakes Medical Center
  • Southern Coos Hospital and Health Center
  • St.Alphonsus Medical Center
  • St.Anthony Hospital
  • St.Charles Health System
  • St.Luke's Hospital
  • Tuality Healthcare (OHSU partner)
  • Wallowa Memorial Hospital
  • Willamette Valley Medical Center

Networks outside of Oregon

Members living in states outside of Oregon can receive in-network care through the following networks.

First Choice Health Network

Members living in most counties in Washington can receive in-network care through First Choice Health Network. It includes thousands of doctors, hospitals and other medical providers across many specialties.

Private HealthCare Systems (PHCS) Network

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Members living outside of Oregon or Washington in the U.S. can see providers in the PHCS Network for in-network care. It is the largest PPO medical network nationwide, with thousands of doctors and clinics, and hundreds of hospitals, to choose from. PHCS Network gives members plenty of choice.

First Health® Network

In 2021, we will be adding First Healthâ to our national network options for large group employers. With over 550,000 in-network providers and one million service locations nationwide, the First Health Network gives members access to quality care to manage their care and healthcare costs whether they are at home or on the road. To learn more, please work with your Moda Health Sales Rep when quoting new business to help your clients choose the right national network wrap for their employee population.

Travel network - First Health Network

When members hit the road, care is never far away. While traveling outside the network service areas, members can receive emergency or urgent care through the First Health Network which is paid at the in-network amount. Traveling for the purpose of seeking care does not qualify for the travel network benefit. Outside the U.S., members may access any provider for emergency care at the in-network cost-sharing amount. This care is subject to balance billing. Other care received outside the U.S. is not covered.

Questions?

We're here to help. Contact our Sales and Account Services team for friendly support.

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Each Delta Dental of Oregon plan comes with a Delta Dental network. It includes thousands of dentists across the state, and the country.

To learn more about our dental networks go to DeltaDentalOR.com.

Questions?

We're here to help. Contact our Sales and Account Services team for friendly support.