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Answers about Moda Health Synergy and Summit provider networks

Which hospitals are in my network?

Moda Health partners with top healthcare facilities across Oregon. These hospitals and health systems participate in our Synergy or Summit network. No matter where you live or work, you can find outstanding in-network providers right near you.

Summit Network
In eastern Oregon, public employees with a Summit medical plan have access to the following hospitals and clinics:

  • Blue Mountain Hospital District
  • CHI St. Anthony Hospital
  • Good Shepherd Health Care System
  • Grande Ronde Hospital
  • Harney District Hospital
  • Kadlec Health System
  • Lake Health District
  • Morrow County Health District
  • Saint Alphonsus Health System
  • Trios Health
  • Walla Walla Clinic
  • Wallowa County Memorial Hospital

Synergy Network
Oregon public employees with a Synergy medical plan have access to these hospitals and health systems. They serve members in the Portland Metro, SW Washington, Salem, Eugene and parts of the Oregon north coast and Columbia River Gorge areas:

  • Adventist Health
  • Asante
  • Bay Area Hospital
  • Columbia Memorial Hospital
  • Legacy Health
  • Legacy Silverton Hospital
  • Mid-Columbia Medical Center
  • Oregon Health & Science University (OHSU)
  • PeaceHealth
  • Salem Health Hospital and Clinics
  • Samaritan Health Services
  • Santiam Hospital
  • Sky Lakes Medical Center (affiliated with OHSU)
  • St. Charles Health System
  • Tuality Healthcare (Partners with OHSU)

What counties does my network cover?

The Summit Network serves members living or working in these counties:

  • Baker
  • Gilliam
  • Grant
  • Harney
  • Lake
  • Malheur
  • Morrow
  • Sherman
  • Umatilla
  • Union
  • Wallowa
  • Wheeler

The Synergy Network serves members who live or work in these counties:

  • Benton
  • Clackamas
  • Clark
  • Clatsop
  • Columbia
  • Coos
  • Crook
  • Curry
  • Deschutes
  • Douglas
  • Hood River
  • Jackson
  • Jefferson
  • Josephine
  • Klamath
  • Lane
  • Lincoln
  • Linn
  • Marion
  • Multnomah
  • Polk
  • Tillamook
  • Wasco
  • Washington
  • Yamhill

Is my doctor is considered "in-network"?

It's easy to see if your primary care provider (PCP) is part of a Moda Health provider network. Just follow these steps:

  1. Go to our online provider directory, Find Care
  2. Choose your network: Synergy (Western Oregon) or Summit (Eastern Oregon)
  3. In the search criteria for Provider Type, choose "Medical Home Clinics & Medical Groups" to search by facilities or “Medical Home Providers & Doctors" to search by provider names.
  4. Enter your location – you may need to adjust the Distance option to expand the search area.
  5. You may create a PDF of the list with the "Download/print results" link under the map.

Still need a hand? We're here to help. Call our Customer Service team toll-free at 844-776-1593.

How do I find a doctor for my son or daughter who lives out of the area?

Your covered dependent children living outside the network service areas can find in-network care through the First Health Network.

Use one of the following options to locate nearby providers:

  • Visit our provider search tool, Find Care and select First Health Network in Network Selection.
  • Visit and choose Locate a Provider to get started.
  • Call Moda Health Customer Service at 844-776-1593 to make sure we have correct information for any children living outside your service area.

Dependent children also need to select a Medical Home in myModa (dependents under 18 need to have the subscriber select one for them). When receiving care in the network service area, child dependents must see providers in their Medical Home for in-network coverage. See the Medical Home overview for more details.

What if my medical home refers me to a specialist outside my network?

You will need to use in-network providers whenever possible. However, on rare occasions there may be no in-network provider for a particular specialty. In that case your medical home must coordinate your referral with Moda Health for you to receive in-network benefits.

With the exception of these special situations, care from a provider outside your network is covered at the out-of-network level.

What if I have an emergency out of my network service area?

If you experience a medical emergency, please get to the nearest emergency room immediately. Your treatment will be covered at the in-network benefit level, based on your maximum plan allowance for emergency services.

Can I get emergency and urgent treatment while traveling?

Yes. Medical plan members can see First Health Network providers for in-network emergency or urgent care when traveling outside the plan network service areas. Traveling for the purpose of seeking care does not qualify for Moda Health's travel network benefit.

Outside the United States, members may access any provider for in-network emergency care. This care is subject to balance billing, the difference between the maximum plan allowance and the billed charges. All other care received outside the U.S. is not covered.

Eligible members must seek in-network services whenever possible, and in-patient services require preauthorization.

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