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Reset FormPrintHEALTH SYSTEMS DIVISION Provider Enrollment Unit Oregon Medicaid Provider Revalidation Form Complete this form only for the provider listed on your revalidation letter. Please print
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How to fill out ohp 3140 provider revalidation

How to fill out ohp 3140 provider revalidation
01
Gather all necessary documents and information, such as your OHP provider number, social security number, and contact information.
02
Download the OHP 3140 Provider Revalidation form from the official website of your state’s Medicaid program.
03
Fill out the form accurately and completely. Provide all requested information, including your personal details, practice location, and services provided.
04
Include any supporting documentation or attachments required, such as copies of licenses, certifications, or accreditation.
05
Review the completed form and double-check for any errors or missing information. Correct any mistakes before submission.
06
Submit the OHP 3140 Provider Revalidation form and any accompanying documents to the appropriate Medicaid office by mail, fax, or electronically, as instructed on the form or the Medicaid program website.
07
Keep a copy of the completed form and supporting documents for your records.
08
Monitor the status of your revalidation application through the Medicaid program’s online portal or by contacting the Medicaid office directly.
09
Respond promptly to any requests for additional information or clarification from the Medicaid office.
10
Follow up with the Medicaid office to ensure that your revalidation is processed in a timely manner.
Who needs ohp 3140 provider revalidation?
01
Providers who participate in the Oregon Health Plan (OHP) and wish to continue providing services to OHP recipients need to complete the OHP 3140 Provider Revalidation. This includes healthcare professionals such as doctors, nurses, dentists, therapists, and other licensed practitioners who bill OHP for their services.
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What is ohp 3140 provider revalidation?
OHP 3140 provider revalidation is a process in which healthcare providers who are enrolled in the Oregon Health Plan (OHP) must confirm and update their information in order to continue receiving reimbursement for services provided to OHP members.
Who is required to file ohp 3140 provider revalidation?
All healthcare providers who are enrolled in the Oregon Health Plan (OHP) are required to file OHP 3140 provider revalidation.
How to fill out ohp 3140 provider revalidation?
To fill out OHP 3140 provider revalidation, healthcare providers must complete the required forms, provide updated information, and submit any supporting documentation as necessary.
What is the purpose of ohp 3140 provider revalidation?
The purpose of OHP 3140 provider revalidation is to ensure that healthcare providers who are enrolled in the Oregon Health Plan (OHP) meet all necessary requirements and continue to provide quality care to OHP members.
What information must be reported on ohp 3140 provider revalidation?
Healthcare providers must report updated contact information, licensure status, accreditations, certifications, services provided, and any other relevant details on OHP 3140 provider revalidation.
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