Form OHP3120 Provider Enrollment Attachment - School Medical - Oregon

Form OHP3120 Provider Enrollment Attachment - School Medical - Oregon

What Is Form OHP3120?

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 OHP3120 Provider Enrollment Attachment?
A: OHP3120 is a form used for provider enrollment attachment specifically for school medical services in Oregon.

Q: Who needs to fill out the OHP3120 form?
A: Healthcare providers offering school medical services in Oregon need to fill out this form.

Q: What information is required on the OHP3120 form?
A: The form requires information such as provider details, service location, billing information, and agreement to comply with program requirements.

Q: Is there a fee for submitting the OHP3120 form?
A: No, there is no fee for submitting the OHP3120 form for provider enrollment attachment.

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Form Details:

  • Released on June 1, 2018;
  • 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 OHP3120 by clicking the link below or browse more documents and templates provided by the Oregon Health Authority.

Download Form OHP3120 Provider Enrollment Attachment - School Medical - Oregon

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