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DIVISION OF MEDICAL ASSISTANCE PROGRAMS Medical Assistance Programs Service Denial Appeal and Hearing Request Oregon Health Authority (OHA) completes this part if a hearing is requested Client ID.

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For complaints about OHP services or providers: For services covered by coordinated care organizations (CCOs), contact the CCO. For other services, contact OHP Client Services (800-273-0557).

If your health care provider tells you that you will need to pay for a service that is not covered, ask to get a Notice of Adverse Benefit Determination that shows the service is not covered. Once you have it, you can ask for an appeal with your CCO or a hearing with OHA (if you are not enrolled in a CCO).

Call Oregon Eligibility (ONE) Customer Service at 800-699-9075 (TTY 711) if you: Have questions about eligibility. Become pregnant or your pregnancy ends. Need help using the ONE system.

For questions, contact Provider Services at 800-336-6016 (option 5) or DMAP.ProviderServices@oha.oregon.gov.

​Use the online hearing form to ask OHA for a fast hearing. ​You can also fax your hearing request form (OHP 3302) to the OHP Hearings Unit at 503-945-6035. Include a statement from your provider explaining why it is urgent.

The Payer ID for Oregon Medicaid is ORDHS. Contact DMAP Provider Services for claims and Provider Web Portal questions (800-336-6016 or dmap.providerservices@state.or.us). Contact EDI Support Services for trading partner agreement status, EDI mailbox assistance or any other EDI-related assistance.

DMAP pays health care costs for eligible low-income Oregonians, funded jointly through state and federal resources.

If you don't report the change, you could have to pay money back when you file your federal tax return. The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232