OAR 410-150-0040: Request Requirements

(1) A completed OHP 729 Administrative Medical Examination/Report Authorization is the prior authorization needed to perform an administrative examination, complete supplemental forms, or send copies of records. (a) Only the version of the OHP 729 series that is current as of the date of request is valid. The current OHP 729 series is available online at https://www.oregon.gov/oha/HSD/OHP/Pages/Policy-Admin-Exam.aspx. (b) Only an employee of the Department of Human Services (DHS) or Oregon Youth Authority (OYA), or the Division (OHA) may complete the OHP 729. (c) Providers must keep a copy of the OHP 729 for seven years. (2) There are a series of OHP 729 forms that may or may not be necessary to complete. Always follow the instructions on the OHP 729. (3) Examinations are only to be completed by the provider type listed on the Administrative Exam and Report Codes table found at https://www.oregon.gov/oha/HSD/OHP/Pages/Policy-Admin-Exam.aspx. (4) An administrative medical examination or report requested must be in compliance with the policies outlined in the Division worker guide found at https://www.oregon.gov/oha/HSD/OHP/Pages/Policy-Admin Exam.aspx. (5) Claims may only be submitted by a Division-enrolled provider who: (a) Is contracted with DHS, 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 OHP 729 form. (6) Providers may only perform the services included on the OHP 729 as requested by a DHS, OYA or Division employee. Providers must: (a) Provide the requested report within 15 days, as noted on the OHP 729, unless there is good cause for a delay. (b) Follow the instructions for all forms received in the OHP 729 series, and (c) Keep a copy of the OHP 729 for seven years. (7) Individuals needing an Administrative Exam who do not have other means of transportation, may use Non-Emergent Medical Transportation (NEMT). Authorizing staff must follow the NEMT Worker Guide, policies and associated rules in Oregon Administrative Rules 410-136.