Information for new providers
If you're newly enrolled with DHS as a provider for medical assistance programs, you need our provider guidelines to help you understand the Oregon Administrative Rules (OARs) that apply to your provider type, and how to correctly submit claims. The table below shows each type of provider in the column on the left. The rest of the row shows the types of provider rules and guidelines you need. Follow these links to the provider pages where you can download the rulebooks and important supplemental information.
Note: Every fee-for-service provider needs General Rules in addition to specific specialty.
General Rules • OHP Rules • AIS • HIPAA
Provider Type |
Rules and Guidelines Needed
|
AFS |
All Provider Rules and Guidelines |
Air Ambulance |
Med Trans |
Alcohol and Drug (Chemical Dependency) |
Contact Alondra Rogers, AMH, (503) 947-5528 |
Ambulance |
Med Trans |
Ambulatory Surgical Center |
Med/Surg |
Audio Therapy |
Speech/Lang. Path |
Billing Provider |
Med/Surg |
Birthing Center |
Med/Surg |
Capitation Org. |
Dental |
Chiropractor |
Med/Surg |
Copy Service |
Admin Exam |
Dentist/Dental Hygienist |
Dental/Denturist |
Denturist |
Dental/Denturist |
Dialysis |
Hospital |
Direct Entry Midwife |
Med/Surg |
Family Planning Clinic |
Med/Surg |
Hearing Aid |
Speech/Language Path
DME |
Home Health |
Home Health, Home Enteral/Parenteral |
Hospice |
Hospice |
Hospital |
Hospital, Med/Surg,
OT/PT, Speech/Lang
|
Independent Lab |
Med/Surg |
Indian Health |
American Indian/Alaska Native
Admin Exam
|
Medical Air Transport |
Med Trans |
Mental Health Clinic |
Contact Alondra Rogers, AMH, (503) 947-5528; Admin Exam |
Misc. Medical |
DME, Ancillary Services |
Misc. Medical and Home Enteral/Parenteral |
DME, Home IV |
Naturopath |
Med/Surg |
Nurse Anesthetist |
Med/Surg |
Nurse Practitioner |
Med/Surg |
Nutritionist |
Med/Surg |
Occupational Therapy |
OT/PT |
Optician, Dispensing |
Visual |
Optometrist |
Visual, Admin Exam |
PCCM |
Med/Surg, Admin Exam |
Physician |
Med/Surg, Admin Exam |
Physician/Ophthalmologist |
Med/Surg, Visual, Admin Exam |
Pharmacy |
Pharmacy |
Physical Therapy |
OT/PT, Admin Exam |
Podiatrist |
Med/Surg |
Polygrapher |
Admin Exam |
Portable X-Ray Service |
Med/Surg |
Prenatal Clinic |
Med/Surg |
Prepaid Health Plans (Managed Care) |
All Provider Rules and Guidelines |
Private Duty Nurse |
PDN, Med/Surg |
Private Duty Nurse w/Home Enteral/Parental Specialty |
PDN, Home IV |
Psychologist |
Admin. Exam |
Public Clinic |
Med/Surg, Dental,
Visual, Admin Exam |
Residential Treatment Center |
Contact Alondra Rogers, AMH, (503) 947-5528; Admin Exam |
Rural Health Clinic |
Rural Health, Admin Exam |
School-Based Health Services |
School-Based |
Social Worker |
Med/Surg, Admin. Exam
|
Special Transport |
Med Trans |
Special Transportation Contract |
Med Trans |
Speech Therapy |
Speech/Lang. Path |
Targeted Case Management |
Med/Surg
TCM Rules |
Taxi |
Med. Trans |
Transportation Broker |
Med Trans |
Wheelchair Transport |
Med. Trans |
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