Get the free OHP 3027. FQHC-RHC Cost Statement Template

State of Oregon Oregon Health Authority Health Systems DivisionThis Box For OHA Use OnlyCOST STATEMENTFederally Qualified Health Centers (FQHC) Rural Health Clinics (RHC)Initial report not reviewed

How to fill out ohp 3027 fqhc-rhc cost

How to fill out ohp 3027 fqhc-rhc cost

1. To fill out OHP 3027 FQHC-RHC cost, follow these steps:
2. Obtain a copy of the OHP 3027 form. You can download it from the official OHP website or request it from the designated authorities.
3. Begin by filling out the top section of the form, which includes the provider's name, address, and contact details.
4. Move on to the second section, which requires you to provide details about the billing period, such as start and end dates.
5. Next, you need to fill in the patient's information, including their name, address, date of birth, and OHP ID number.
6. Proceed to the 'Services Provided' section of the form. Here, you will need to list each service provided to the patient during the billing period, along with the corresponding dates of service, CPT codes, and charges.
7. Make sure to accurately calculate the total cost for each service and enter the grand total in the designated field.
8. Provide any additional explanations or information required in the 'Comments' section, if applicable.
9. Finally, review the completed form to ensure all fields are correctly filled out and that there are no errors or omissions.
10. Sign and date the form, and submit it according to the specified guidelines. Retain a copy for your records.

Who needs ohp 3027 fqhc-rhc cost?

1. OHP 3027 FQHC-RHC cost is needed by healthcare providers who operate a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) and participate in the Oregon Health Plan (OHP).
2. This form is specifically used for reporting and documenting the costs associated with providing services to OHP members at FQHCs and RHCs.
3. By submitting this form, providers can seek reimbursement from OHP for the covered services rendered to eligible patients.
4. It is important for FQHCs and RHCs to accurately fill out this form to ensure proper reimbursement and compliance with OHP regulations.

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What is ohp 3027 fqhc-rhc cost?

OHP 3027 FQHC-RHC cost refers to the cost report filed by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to provide detailed financial information for reimbursement purposes.

Who is required to file ohp 3027 fqhc-rhc cost?

Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) that receive Medicaid reimbursement are required to file the OHP 3027 cost report.

How to fill out ohp 3027 fqhc-rhc cost?

To fill out OHP 3027, providers must gather financial data, including costs associated with patient care, and complete the report forms accurately according to the provided instructions.

What is the purpose of ohp 3027 fqhc-rhc cost?

The purpose of OHP 3027 FQHC-RHC cost report is to document costs incurred by the clinics for providing healthcare services and to calculate reimbursement rates from Medicaid.

What information must be reported on ohp 3027 fqhc-rhc cost?

The report must include detailed financial information such as total revenue, expenses, patient visits, and cost attribution for healthcare services provided.