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  • Dmap 3113 Ffs Non-payable Provider Enrollment Form

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DIVISION OF MEDICAL ASSISTANCE PROGRAMS Provider Enrollment Unit NonPayable Provider Enrollment Form Use this form to enroll providers with Oregon Medicaid for reasons other than direct reimbursement.

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Division of Medical Assistance Programs (DMAP means a Division, within the Oregon Health Authority, responsible for coordinating the medical assistance programs within the State of Oregon including the Oregon Health Plan Medicaid demonstration, the State Children's Health Insurance Program, and several other programs.

DMAP pays health care costs for eligible low-income Oregonians, funded jointly through state and federal resources. DMAP is currently implementing a federal waiver demonstration project to expand the Medicaid program under the Oregon Health Plan, monitored by the Center for Medicare and Medicaid Services.

All DMAP Administrative Rules, guidelines and applications to become an enrolled DMAP provider can be found on the DMAP Web site at .oregon.gov/OHA/healthplan. For billing questions, call DMAP Provider Services toll-free at 800-336-6016 or send an e-mail to DMAP.ProviderServices@state.or.us.

Call Provider Enrollment at 800-336-6016 (option 6) or email provider.enrollment@odhsoha.oregon.gov​.

Call 800-699-9075 (open 7 a.m. to 6 p.m. Pacific Time, Monday through Friday). Find other ways to get help applying for OHP.

Call Provider Enrollment at 800-336-6016 (option 6) or email provider.enrollment@odhsoha.oregon.gov​.

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© Copyright 1997-2025
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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