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.
Q: What is Form OHP3103?
A: Form OHP3103 is a Provider Enrollment Attachment for Targeted Case Management in Oregon.
Q: What is Targeted Case Management?
A: Targeted Case Management is a service that helps individuals with complex health needs navigate the healthcare system and access necessary services.
Q: Who should complete Form OHP3103?
A: Providers who offer Targeted Case Management services in Oregon should complete Form OHP3103.
Q: Is Form OHP3103 mandatory for Provider Enrollment?
A: Yes, providers offering Targeted Case Management services in Oregon must complete Form OHP3103 for enrollment.
Q: Are there any specific requirements for completing Form OHP3103?
A: Yes, providers must ensure that all required fields are filled out accurately and provide supporting documentation as requested.
Q: Who can I contact for help with Form OHP3103?
A: For assistance with Form OHP3103, you can contact the Oregon Health Plan Provider Enrollment department.
Q: What other documents may be required for Provider Enrollment?
A: In addition to Form OHP3103, providers may be required to submit other documents such as proof of licensure, certifications, or professional liability insurance.
Q: Is there a deadline for submitting Form OHP3103?
A: The deadline for submitting Form OHP3103 may vary, so it is important to check with the Oregon Health Plan for the latest information.
Form Details:
Download a fillable version of Form OHP3103 by clicking the link below or browse more documents and templates provided by the Oregon Health Authority.