A Community of World-class Physicians & Ancillary Providers

For Providers

Aspire contracts with a community of world-class physicians and ancillary providers who care deeply about the community. This dedication to the health and well-being of Aspire Health Plan members makes our provider network an important part of the Aspire Health Plan team.

The information on this page should help providers navigate the services for Aspire Health Plan. If you are unable to find the information you need on this page, please call Member Services at (831) 574-4938 or (855) 570-1600 for questions about eligibility and benefits or call Aspire’s Provider Services Team at (831) 657-0700, or email us at Network_Support@AspireHealthPlan.org.

Aspire Health Plan and MBIPA – Contact Information

Medical Authorizations

Aspire Health Plan
Submit authorization requests electronically on the provider portal.

If you do not have a portal account and would like to establish one, please call (503) 584-2169

Call: (831) 574-4938 or (855) 570-1600
Fax: (831) 657-2669

  • 2024 Authorization Request Form (PDF):

    (Last Revised 4/2024)  English  |  Español

Services that Require Prior Authorization (Authorization List):

  • Inpatient admissions
  • Durable Medical Equipment over $500
  • Inpatient rehabilitation facility
  • External Prosthetic Devices over $500
  • Skilled Nursing Facility
  • CT, MRI/MRA, PET scan, Nuclear Medicine (including SPECT), Angiography
  • Genetic and Molecular Diagnostic Testing
  • Mental health partial hospitalization
  • Radiation Oncology
  • Outpatient Surgery (including wound care)
  • Select Part D drugs (see formulary for details)
  • Select Part B drugs (see drug coverage for details)
  • Non-emergent Ambulance
  • Non-contracted providers
  • Intensive Outpatient Substance Abuse services
  • Any Out-of-Network Referrals
  • Occupational, Physical, Speech Therapy (after 12 visits, per calendar year)
  • Home Health Services

Claims Submission

Electronic Submission
  • Clearing House:
    Office Ally — www.officeally.com
    Payor ID: ASP01
    Office Ally phone number: (866) 575-4120
  • Clearing House: (currently unavailable)
    Payor ID: 46156

For electronic claim submission assistance, please email edi.support@phtech.com or call (503) 584-2169 option 1

Paper Submission
  • Aspire Health Plan
    P.O. Box 5490
    Salem, OR 97304

For paper claim submission assistance, please call (855) 570-1600

Payment Integrity

At Aspire Health Plan, we are dedicated to safeguarding the financial well-being of our members and being responsible stewards of healthcare resources. Our commitment to payment integrity is a testament to our mission of delivering high-quality care to our members while ensuring fiscal responsibility.

Guided by CMS (Centers for Medicare & Medicaid Services) regulations and industry best practices, we have established a robust program and engaged a vendor, Integrity Advantage, to support our payment integrity efforts. We understand that a sustainable healthcare system relies on accurate and accountable financial practices.