C3CAP - Service Guide
c3cap@
503-345-6732
C3CAP - Service Guide
__________________________________________________________________________________________
Directions: This guide outlines the available vendors, services and the appropriate workflow for submitting a Service Request.
-Order Online indicates that the service must be ordered online through the designated Website and recorded in Clara.
-Website indicates the appropriate website that should be used in addition to tracking your request in Clara.
-Pend indicates that the service or vendor will automatically pend once submitted in Clara. C3CAP will need to approve and/or take action to complete this Service Request.
-Print indicates that the voucher generated by Clara should be printed and presented at the time of scheduling or using the service.
-Special Instructions highlight any additional information you may need.
If you ever have any questions, please feel free to call the C3CAP team. We are happy to help.
Medicaid Flex Spending
Categories
Services
Vendors
Order
Online
Website
Pend
Print
Voucher
Special Instructions
1. Training/education for health
improvement or management (e.g. class
on healthy meal preparation or diabetes
self-management curriculum)
Chronic Disease
Management &
Prevention
Project Access NOW
No
-
Yes
No
-
2. Self-help or support group activities
(e.g. post-partum depression programs,
Weight Watchers groups)
Self Help/Support
Project Access NOW
No
-
Yes
No
-
Linguava
No
-
No
No
-
3. Care coordination, navigation, or case
management activities (not covered under
Interpretation
State Plan benefits, e.g. high utilizer
intervention program)
Clothing/Shoes
Durable Medical
Equipment
Home Equipment &
Supplies
4. Home/living environment items or
Oral Hygiene
improvements (non-DME items to improve
mobility, access, hygiene, or other
improvements to address a particular
health condition, e.g. air conditioner,
athletic shoes or other special clothing)
Target
Yes
Yes
No
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
Beaverton Pharmacy DME
No
-
No
Yes
Please fax this voucher to the
vendor when requesting service.
Lincare Holdings
Norco Medical Portland
No
No
-
No
No
Yes
Yes
-
Home Depot
Yes
No
No
You will be purchasing items on
behalf of your client. Purchasing
instructions are in Clara.
Lowes
Yes
No
No
You will be purchasing items on
behalf of your client. Purchasing
instructions are in Clara.
Amazon
Yes
smile.
Yes
No
Target
Yes
Yes
No
Amazon
Yes
smile.
Yes
No
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
No
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
No
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
No
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
Sensory Items
Target
Yes
Amazon
Yes
smile.
Yes
Yes
Supplies
Target
5/10/2016
Yes
1/4
Yes
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
v.0.0.5
c3cap@
503-345-6732
C3CAP - Service Guide
__________________________________________________________________________________________
Medicaid Flex Spending
Categories
Services
Ambulance
Wheelchair/Gurney
Vendors
Order
Online
Website
Pend
Print
Voucher
Special Instructions
American Medical Response
Northwest
No
-
No
Yes
-
B&R Medical Transport
No
-
No
Yes
-
Community Ambulance
No
-
No
Yes
-
Metro West
No
-
No
Yes
-
B&R Medical Transport
No
-
No
Yes
-
Mobile Care, WC and Gurney
No
-
No
Yes
-
Net Care
No
-
No
Yes
-
No
Super Users can order passes for
their department at . All
users should record distribution to
clients in Clara.
Canby Area Transit
Local bus ride
Yes
No
Columbia Area Transit
Yes
No
No
Columbia County Rider
Yes
No
No
The Wave/Tillamook Bus
No
-
No
Yes
-
Trimet
Yes
No
No
Super Users can order passes for
their department at . All
users should record distribution to
clients in Clara.
Green Shuttle for Wheelchairs
No
-
No
Yes
Wheelchair must be between 26"
(standard size) and 32" wide.
Paratransit
5. Transportation not covered under State
Plan benefits (such as transportation to a
medical appointment)
Secure
Transportation
Taxi Cab Services
Air Fare
Gas cards
Greyhound Bus
Long Distance Bus
Ride
Train Ride
5/10/2016
Super Users can order passes for
their department at . All
users should record distribution to
clients in Clara.
Super Users can order passes for
their department at . All
users should record distribution to
clients in Clara.
Trimet Lift
Yes
No
No
Clients must apply and be approved
by Trimet to use this service.
Following approval, Trimet passes
can be used for fare.
Mountain Retreat
No
-
No
Yes
-
NW Regional Secure Transport
No
-
No
Yes
-
Secure Transport
No
-
No
Yes
-
Advance Taxi
No
-
No
Yes
-
Broadway Cab
No
-
No
Yes
-
Care More Cab
No
-
No
Yes
-
Diamond Cab Company
No
-
No
Yes
-
Gorge Yellow Cab
No
-
No
Yes
-
Green Transportation
No
-
No
Yes
-
Metro Medical Taxi
No
-
No
Yes
-
Radio Cab
No
-
No
Yes
-
Willamette Valley Transport
No
-
No
Yes
-
Project Access NOW
No
-
Yes
No
C3CAP will purchase ticket and
email to you.
Yes
Record car's model, make, year, and
milage in Clara. C3CAP will mail the
card to the designated mailing
address.
Yes
Use website to plan trip. Record
details in Clara. C3CAP will
purchase ticket and provide you with
a confirmation number and if the
client does not have valid id - a
password. Please record this
information on the voucher and give
to client.
Shell
No
Greyhound
Yes
-
Yes
Yes
The Point
Yes
Yes
No
Use website to plan trip. Record
details in Clara. C3CAP will
purchase ticket and email to you.
Amtrak
Yes
home
Yes
No
Use website to plan trip. Record
details in Clara. C3CAP will
purchase ticket and email to you.
2/4
v.0.0.5
c3cap@
503-345-6732
C3CAP - Service Guide
__________________________________________________________________________________________
Medicaid Flex Spending
Categories
Services
Cleaning
Vendors
Order
Online
Website
Pend
Print
Voucher
Special Instructions
Helping Hand Cleaners
No
-
No
Yes
Please fax this voucher to the
vendor when requesting service.
Home Depot
Yes
No
No
You will be purchasing items on
behalf of your client. Purchasing
instructions are in Clara.
Lowes
Yes
No
No
You will be purchasing items on
behalf of your client. Purchasing
instructions are in Clara.
Helping Hands Home Care
No
-
No
Yes
Please fax this voucher to the
vendor when requesting service.
6th Avenue Motel
No
-
No
Yes
-
Beaverton Budget Inn
No
-
No
Yes
-
Best Western Newberg Inn
No
-
No
Yes
-
Best Western Sandy Inn
No
-
No
Yes
-
Budget Lodge/Milwaukie Inn
No
-
No
Yes
-
Cascade Inn
No
-
No
Yes
-
Days Inn Clackamas
No
-
No
Yes
-
Days Inn Portland
No
-
No
Yes
-
Eastside Lodge Portland
No
-
No
Yes
-
Econo Lodge - Hillsboro
No
-
No
Yes
-
No
-
No
Yes
-
No
-
No
Yes
-
No
-
No
Yes
-
No
-
No
Yes
-
No
-
No
Yes
-
Extended Stay America - Tigard
No
-
No
Yes
-
Golden Knight
No
-
No
Yes
-
Holiday Motel
No
-
No
Yes
-
Lone Pine Motel
No
-
No
Yes
-
Motel 6 - Clackamas
No
-
No
Yes
-
Prater's Motel
No
-
No
Yes
-
Ranch Inn
No
-
No
Yes
-
Shilo Inn - Beaverton
No
-
No
Yes
-
Shilo Inn - Newberg
No
-
No
Yes
-
Shilo Inn Eastside
No
-
No
Yes
-
Sunset Motel
No
-
No
Yes
-
Travelodge
No
-
No
Yes
-
Vagabond Lodge Hood River
No
-
No
Yes
-
Viking Motel
No
-
No
Yes
-
Helping Hand Cleaners
No
-
No
Yes
Please fax this voucher to the
vendor when requesting service.
Fairhaven House 4 - Men's
Home Beaverton
No
-
No
Yes
-
Home Repairs
Home
Support/Services
7. Housing supports related to social
determinates of health (e.g. shelter,
utilities, critical repairs)
Hotel/Motel
Muck out
5/10/2016
Econo Lodge Southeast Milwaukie
Extended Stay America Beaverton
Extended Stay America Beaverton Eider Ct.
Extended Stay America Gresham
Extended Stay America Hillsboro
3/4
v.0.0.5
c3cap@
503-345-6732
C3CAP - Service Guide
__________________________________________________________________________________________
Medicaid Flex Spending
Categories
Services
Vendors
Order
Online
Website
Pend
Print
Voucher
Special Instructions
Fairhaven House 5-Women and
Children's Home
No
-
No
Yes
-
Fairhaven House 6-Men's Home
Portland SE 150th
No
-
No
Yes
-
Fairhaven House 7 Scappoose
No
-
No
Yes
-
No
-
No
Yes
-
No
-
No
Yes
-
Fresh Start Recovery Homes
No
-
No
Yes
-
House of Hope
No
-
No
Yes
-
Just Us Recovery Homes
No
-
No
Yes
-
Transitions for Women
No
-
No
Yes
-
Fairhaven House 8-Men's Home
Beaverton
Fairhaven House 9-Men's Home
Tigard
Recovery Housing
Program (Clean
and Sober)
7. Housing supports related to social
determinates of health (e.g. shelter,
utilities, critical repairs)
-
No
Yes
-
No
-
No
Yes
-
Fairhaven House 11-Men's
Home-Portland SW Delmont
No
-
No
Yes
-
Fairhaven House 1-Men's Home
Portland
No
-
No
Yes
-
Fairhaven House 2-Mens Home
Beaverton
No
-
No
Yes
-
Fairhaven House 3-Women's
Home Beaverton
No
-
No
Yes
-
Shelter
City Team Ministries
Yes
No
No
Supportive Moving
and Hauling
Services
All-American Moving
No
-
No
Yes
-
Supportive Services Moving of
Oregon
No
-
No
Yes
-
Project Access NOW
No
-
Yes
No
Be prepared to provide detailed
payment information when
submitting this request.
No
Vendor will perform an intake
interview prior to acceptance into the
program. Please complete this
request once the client has been
accepted.
No
Please provide copies of bills,
invoices or notices with the
appropriate account information to
facilitate payment.
No
Vendor will perform an intake
interview prior to acceptance into the
program. Please complete this
request once the client has been
accepted.
Respite
Utility Assistance
Recuperative Care
Program
8. Assistance with food, or social
resources (e.g. supplemental food, referral Food Delivery
to job training or social services)
5/10/2016
No
Super Users can order passes for
their department at . All
users should record distribution to
clients in Clara.
Rental Assistance
9. Other (describe)
Fairhaven for Women
Fairhaven House 10-Men's
Home Vancouver
HARP
No
Project Access NOW
No
Central City Concern
No
-
-
-
Yes
Yes
Yes
Amazon
Yes
smile.
Yes
No
Cell Phone
Project Access NOW
No
-
Yes
Yes
Other Assistance
Project Access NOW
No
-
Yes
No
Visa Gift Cards
Project Access NOW
No
-
Yes
Yes
4/4
You will be creating a wishlist of
items that will be used by C3CAP to
purchase. Detailed instructions are
in Clara.
C3CAP will purchase a cell phone or
minutes and send to the designated
address.
Select Other Assistance when
another vendor does not meet your
needs. Contact C3CAP to make
payment arrangements.
C3CAP will mail the card to the
designated mailing address.
v.0.0.5
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