Form OHP1074 Request for Prior Authorization of Out-of-State Services - Oregon

What Is Form OHP1074?

This is a legal form that was released by the Oregon Health Authority - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form OHP1074?
A: Form OHP1074 is a request form for prior authorization of out-of-state services in Oregon.

Q: Why do I need prior authorization for out-of-state services?
A: Prior authorization is required to ensure that the out-of-state services will be covered by your Oregon Health Plan (OHP) benefits.

Q: What information is required on Form OHP1074?
A: Form OHP1074 requires information such as your personal details, the out-of-state service you are requesting, and the medical justification for the request.

Q: How long does it take to process a prior authorization request?
A: The processing time for a prior authorization request can vary, but it typically takes about 10 business days.

Q: What happens after I submit Form OHP1074?
A: After you submit Form OHP1074, the request will be reviewed by the Oregon Health Plan to determine if the out-of-state service meets the necessary criteria for coverage.

Q: Can my request for out-of-state services be denied?
A: Yes, the Oregon Health Plan may deny your request for out-of-state services if it does not meet the required criteria for coverage.

Q: What should I do if my request is denied?
A: If your request for out-of-state services is denied, you can contact the Oregon Health Plan for more information on the denial and the appeal process.

Q: Can I appeal the denial of my prior authorization request?
A: Yes, you have the right to appeal the denial of your prior authorization request for out-of-state services.