Tools for providers

Contact us (PDF)

• Who do I call for help and where do I send my forms?

The Plan Drug List (PDL)

• An overview of the Plan Drug List.
  
• Weekly 7-11 carve-out list, Excel | PDF
   

Billing Tips and Training Opportunities

• Common FFS billing errors (pdf)
• How to complete billing forms
• How to read a Remittance Advice
• DMAP provider training (ppt)

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Contracts (Managed Care) more

• Chemical Dependency Organizations
• Dental Care Organizations
• Fully Capitated Health Plans
• Physician Care Organizations
• Requests for applications

Electronic Business Practices

• Introduction
• Basics of Electronic Data Interchange (EDI)
• EDI 101, a beginner's manual (PDF)

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Eligibility Verification more

• Automated Information System (AIS)
• Electronic Eligibility Verification Services (EEVS)
• Electronic Data Interchange 270/271 transactions

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Fraud and abuse

• Employee Education about False Claims Recoveries (PDF)
• DHS Fraud Reporting and Investigations
• DHS Fraud Referral Database

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Frequently Asked Questions (FAQs)

• General FAQs
  HIPAA and Electronic Data Interchange
  OHP Plus and OHP Standard

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Forms for Health Care Providers

• Download OMAP forms
• How to complete a claim form

HIPAA more and Electronic Data Interchange (EDI) more

• EDI registration and testing
• Companion guides and manuals
• HIPAA reports and news from DHS

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New providers more

• How to enroll as an OHP provider
• Keys to Success--Partnering with DMAP (PDF)
• What provider materials do you need?

See also: Electronic Business Practices or paper billing tips

Outreach sites more

• FAQs
• Do's and don'ts
• Forms

Provider rules and guidelines

Payment Error Rate Measurement (PERM)

• Would you like to learn more about PERM?
• PERM Frequently Asked Questions

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Pharmacy providers more

• Senior Prescription Drug Assistance Program
• Provider rules and guidelines
• Proposed rule revisions, notices of rule-making and hearings
• Pharmacy provider announcements

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Policies

• Rules (OARs) and Guidelines:
  DME • General Rules • OHP • Pharmacy • more
• Notices of rulemaking, proposed revisions and hearings more

Prioritized list, fees, rates and costs more

• Prioritized List of Health Conditions
  Fee schedule (fee-for-service)
  Capitation rates and per capita costs
  Excluded and below-the-line diagnosis list (PDF)

Provider tax rules and forms

Reports and announcements

• OHP eligibles
• OHP Managed care plan enrollment
• Provider announcements
• Pharmacy program announcements
• Connections, provider newsletters
• System Alerts

School-Based Health Services

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