|
How to become an Oregon Health Plan provider
To bill DMAP for services delivered on a fee-for-service ("open card") basis to OHP clients, providers need to enroll with DMAP and receive an Oregon Medicaid provider number for billing.
If you have questions about becoming a fee-for-service OHP provider, call DMAP Provider Enrollment at 1-800-422-5047 or e-mail provider.enrollment@state.or.us. If you have questions about providing services through an OHP managed care plan, contact the plan.
Need to check the status of your enrollment request with DMAP? Try our online enrollment tracking.
Who can enroll?
| Payable providers |
Any providers who bill and receive direct reimbursement by DMAP for health care services. This includes out of state providers who serve OHP clients not enrolled in an OHP medical or dental plan.
- Mental health providers must secure a contract with a contracted Mental Health Organization (MHO) or Community Mental Health Program (CMHP) in order to deliver services to OHP clients. Refer to the AMH Provider Manual for more information.
- Rendering providers (such as practitioners of a clinic or hospital who bills on their behalf).
|
| Non-payable providers |
Providers who need to be enrolled in DMAP’s system for reasons other than direct reimbursement by DMAP for health care services. These include:
- Individual practitioners in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and tribal health centers who need to apply for federal Medicaid EHR Incentives through the "EHR incentive" screen of the Provider Web Portal at https://www.or-medicaid.gov;
- Providers who need access to OHP eligibility verification resources through Automated Voice Response or the Provider Web Portal;
- Providers whose only relationship with DMAP is to order, prescribe, or refer (not provide) services for OHP clients, as required by the federal Affordable Care Act;
- Prescribing providers at FQHCs, RHCs, tribal health centers, mental health clinics, chemical dependency clinics, public health clinics, and school-based clinics;
- Providers contracted with OHP medical and dental plans.
If a hospital bills DMAP for your services, enroll as a non-payable provider; DMAP will pay the hospital.
For dental hygienists, if the dentist or dental clinic bills on your behalf, enroll as a non-payable provider; DMAP will pay the dentist/clinic for your services.
|
How to enroll with DMAP
Step 1:
Complete required forms: |
Payable providers: Print and use this checklist to ensure you complete everything you need to get started as an OHP provider.
Non-payable providers: Complete the DMAP 3108 (PDF). |
Step 2:
Send us your information: |
Medical/dental providers: Fax completed forms to 503-378-3074 (Salem). Fax in each enrollment request with all required documentation under its own EDMS coversheet. Missing or incomplete documentation may delay your enrollment.
Mental health providers: Mail completed forms to:
AMH Medicaid Policy Analyst
500 Summer St NE, E86
Salem OR 97301 |
Step 3:
Sign up for direct deposit |
Make sure to complete the DHS 189 (Direct Deposit Authorization Form) to receive your payments securely and electronically.
- For Medicaid EHR Incentive Program payments - Enter the Oregon Medicaid provider number and account information associated with the payee you identified when registering with CMS for EHR incentive payments.
|
How to stay enrolled
To maintain your active provider status and ensure uninterrupted claim processing, keep your information current as required by DMAP General Rule 410-120-1260(10) (Provider Enrollment Required Updates).
| Submit updates within 30 days of the change |
To do this:
|
| License updates |
Send us a copy of your licensure renewal when you receive it from your licensing board. |
|
