Information for new providers

If you're newly enrolled with DHS as a provider for medical assistance programs, you need the department’s provider guidelines to help you understand the Oregon Administrative Rules (OARs) that apply to your provider type, and how to correctly submit claims.

• Guidelines by provider type
• Other helpful links

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Guidelines by provider type

The table below shows each type of provider in the column on the left. The rest of the row shows the types of provider rules and guidelines you need. Follow these links to the provider pages where you can download the rulebooks and important supplemental information.

• Every fee-for-service provider needs General Rules and OHP Rules in addition to their program-specific guidelines. These rules contain important information about eligibility verification, provider rules that apply to all programs, and information about coverage according to the Prioritized List of Health Services.
• Managed care organizations, rural health clinics, and federally qualified health centers must refer to all appropriate rules and guidelines for the services they provide including General Rules and OHP Rules.
• Keep current with the guidelines posted at these links, depending on your provider type:
  • DMAP provider guidelines 
  • SPD provider guidelines 
  • AMH provider guidelines  

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Other helpful links

• Go to the EDI Web site for information on how to bill, obtain claim status, and receive remittance advices via Electronic Data Interchange (EDI). 
• For information about how to verify eligibility for DHS medical assistance clients, go to the Eligibility Verification Web page. 
• Want to receive payments from DHS using direct deposit? Complete and follow the instructions on this form to get started. 

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