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  • Ohp 3140. Provider Revalidation Form

Get Ohp 3140. Provider Revalidation Form

Print HEALTH SYSTEMS DIVISION Provider Enrollment Unit Clear Form Provider Revalidation Form Complete this form for each provider you want to revalidate with Oregon Medicaid. Please print or type.

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Contact support

∎ To change CCOs, call OHP Client Services at 1-800-273-0557. If you are a Health Share of Oregon member: If you want to change your Health Share of Oregon medical plan, contact Health Share Customer Service at 1-888-519-3845.

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

If you still need help, call Provider Services at 800-336-6016.

Income & Asset Limits for Eligibility 2023 Oregon Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleIncome LimitAsset LimitInstitutional / Nursing Home Medicaid$2,742 / month*$2,000Medicaid Waivers / Home and Community Based Services$2,742 / month†$2,0001 more row • Jan 10, 2023

Division of Medical Assistance Programs (DMAP) -- The division of the Oregon Health Authority responsible for coordinating medical assistance programs.

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.

The Oregon Health Plan (OHP) is Oregon's Medicaid program. There are several health care programs available for low-income Oregonians through OHP.

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.

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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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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