OAR 410-133-0280

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. 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) Timely Submission of Claims and 410-120-1397 (Recovery of Overpayments to Providers — Recoupments and Refunds) Recovery of Overpayments to Providers — Recoupments and Refunds.
[ED. NOTE: Forms referenced available from the agency.]
Last Updated

Jun. 8, 2021

Rule 410-133-0280’s source at or​.us