Or. Admin. R. 410-133-0280 - Rebilling
Current through Register Vol. 60, No. 12, December 1, 2021
In order to correct a claim reimbursed for services provided to a Medicaid-eligible student, the School Medical (SM) provider must request an adjustment. The paid claim must be corrected on the Individual Adjustment Request Form (OHP 1036) to allow revision of the original claim. Providers may perform online claim submissions and adjustments using the Authority's web portal. The link can be found at: https://www.or-medicaid.gov [File Link Not Available]. Rebilling additional units of service on a CMS-1500 for the same timeframe would be denied as duplicate services. See 410-120-1300 Timely Submission of Claims and 410-120-1397 Recovery of Overpayments to Providers - Recoupments and Refunds.
Forms referenced available from the agency.
Statutory/Other Authority: ORS 413.042 & 414.065
Statutes/Other Implemented: ORS 413.042 & 414.065
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