OHP and CCO Credentialing for Group Practices: How Oregon Medicaid Actually Works
Oregon Medicaid credentialing is two separate processes and almost everyone discovers the second one late. First you enroll as a provider with the Oregon Health Authority, which covers open-card fee-for-service. Then you separately contract and credential with each Coordinated Care Organization serving the area where your clients live. Finishing step one does not get you paid by a CCO.
Private Pay vs. Insurance (and Medicaid vs. Private): Choosing Your Payer Mix
Your payer mix — private pay, commercial insurance, Medicaid, Medicare, or a blend — is one of the biggest decisions you'll make, because it shapes both your revenue and who can access your care. In short: private pay usually pays the most per session and is simplest to run, insurance reaches far more clients but pays less and adds admin, and Medicaid reaches the people with the fewest options. Here's how to weigh them.
How to Start a Group Therapy Practice in Oregon: Licensing, LLC & Payer Basics
Starting a group therapy practice in Oregon comes down to four things: making sure your (and your clinicians') licenses are in order, choosing and registering a business entity, getting credentialed with the payers you want to accept, and understanding Oregon's specific rules for Medicaid and behavioral health. Oregon does a few things differently than other states — especially its coordinated-care Medicaid system and a Certificate of Approval requirement — so here's what to know before you build. I've walked this path myself building Sprout Therapy PDX from solo to 40+ clinicians, and I'll flag the Oregon-specific traps along the way.