ADMINISTRATIVE EXAMINATION AND BILLING SERVICES
(1) “Administrative Medical Examinations and Reports” is defined in Oregon Administrative Rule (OAR) 410-120-0000.
(2) A completed DMAP 729 Administrative Medical Examination/Report Authorization is authorization for the provider to furnish services.
(3) Only an employee of the Department of Human Services (Department), or Oregon Youth Authority (OYA) or the Division of Medical Assistance (Division) may request an administrative medical examination or report. Department, OYA and Division employees must request administrative medical examinations and reports in compliance with the policies outlined in the Division worker guide located at http://www.oregon.gov/oha/healthplan/tools/DMAP%20Worker%20Guide.pdf.
(4) Claims may only be submitted by a Division-enrolled provider who:
(a) Is contracted with the Department, OYA or the Division to provide Administrative Medical Examinations and Reports;
(b) Meets acceptable source criteria for the agency making the request; and
(c) Has received a completed DMAP 729 form.
(5) Providers may only perform the services included on the DMAP 729 as requested by a Department, OYA or Division employee. Providers must:
(a) Follow the instructions for all forms received in the DMAP 729 series, and
(b) Keep a copy of the DMAP 729 for seven years.
[ED. NOTE: Forms referenced rule are available from the agency.]
Stats. Implemented: ORS 414.065
Hist.: OMAP 27-2000, f. 9-28-00, cert. ef. 10-1-00; OMAP 22-2003, f. 3-26-03, cert. ef. 4-1-03; DMAP 46-2012, f. 10-11-12, cert. ef. 10-15-12
Oregon State Archives • 800 Summer St. NE • Salem, OR 97310