Form OHP3166 Ohp Client Agreement to Pay for Pharmacy Services - Oregon

Form OHP3166 Ohp Client Agreement to Pay for Pharmacy Services - Oregon

What Is Form OHP3166?

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 OHP3166?
A: OHP3166 is the Ohp Client Agreement to Pay for Pharmacy Services form in Oregon.

Q: What does the OHP3166 form do?
A: The OHP3166 form is used to authorize the client to pay for pharmacy services that are not covered by the Oregon Health Plan (OHP).

Q: Who needs to fill out the OHP3166 form?
A: Clients who are enrolled in OHP and wish to pay for pharmacy services that are not covered by OHP need to fill out the OHP3166 form.

Q: Are there any fees associated with the OHP3166 form?
A: No, there are no fees associated with the OHP3166 form.

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Form Details:

  • Released on January 1, 2020;
  • The latest edition provided by the Oregon Health Authority;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OHP3166 by clicking the link below or browse more documents and templates provided by the Oregon Health Authority.

Download Form OHP3166 Ohp Client Agreement to Pay for Pharmacy Services - Oregon

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