Or. Admin. R. 410-125-2080 - Administrative Errors

Current through Register Vol. 60, No. 12, December 1, 2021

(1) If a hospital has been given incorrect information by Division of Medical Assistance Programs, Children, Adults, and Families Programs, or Aging and People with Disabilities/staff, and services were provided on the basis of this information, and payment has been denied as a result, the hospital may submit a request for payment as an Administrative Error.
(2) Include the following:
(a) An explanation of the problem;
(b) Any documents supporting the request for payment;
(c) A copy of any paper Remittance Advice or electronic 835 printouts received on this claim;
(d) A copy of the original claim.
(3) Send the request: Division of Medical Assistance Programs, Provider Inquiry, Administrative Errors, 500 Summer Street NE, E-44, Salem, OR 97301-1077.

Notes

Or. Admin. R. 410-125-2080
AFS 49-1989(Temp), f. 8-24-89, cert. ef. 9-1-89; AFS 72-1989, f. & cert. ef. 12-1-89; HR 21-1990, f. & cert. ef. 7-9-90, Renumbered from 461-015-0730; HR 42-1991, f. & cert. ef. 10-1-91; OMAP 70-2004, f. 9-15-04, cert. ef. 10-1-04; OMAP 17-2006, f. 6-12-06, cert. ef. 7-1-06

Stat. Auth.: ORS 413.042

Stats. Implemented: ORS 414.065

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