Form OHP3105 Provider Enrollment Attachment - Independent Radiology - Oregon

What Is Form OHP3105?

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 the OHP3105 Provider Enrollment Attachment?
A: The OHP3105 Provider Enrollment Attachment is a form used for provider enrollment in Oregon Health Plan (OHP) for Independent Radiology services.

Q: Who is this form for?
A: This form is for Independent Radiology providers who wish to enroll in the Oregon Health Plan (OHP).

Q: What information is required in the form?
A: The form requires information about the provider's business, contact information, services provided, and other enrollment details.

Q: What is the purpose of this form?
A: The purpose of this form is to collect necessary information from Independent Radiology providers in order to enroll them in the Oregon Health Plan (OHP).