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.


Or. Admin. R. 410-133-0280
HR 39-1991, f. & cert. ef. 9-16-91; OMAP 53-2003, f. 8-13-03 cert. ef. 9-1-03; OMAP 24-2005(Temp), f. & cert. ef. 4-5-05 thru 10-1-05; OMAP 53-2005, f. 9-30-05, cert. ef. 10-1-05; DMAP 43-2008, f. 12-17-08, cert. ef. 12-28-08; DMAP 19-2009, f. 6-12-09, cert.ef. 7-1-09; DMAP 52-2018, minor correction filed 05/25/2018, effective 5/25/2018

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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