OAR 407-120: Provider Rules

28 rules in Division 120, Chapter 407 (Department of Human Services).

  1. OAR 407-120-0100: Definitions
  2. OAR 407-120-0110: Purpose
  3. OAR 407-120-0112: Scope and Sequence of Electronic Data Transmission Rules
  4. OAR 407-120-0114: Provider Enrollment Agreement
  5. OAR 407-120-0116: Web Portal Submitter
  6. OAR 407-120-0118: Conduct of Direct Data Entry Using Web Portal
  7. OAR 407-120-0120: Registration Process — EDI Transactions
  8. OAR 407-120-0130: Trading Partner as EDI Submitter – EDI Transactions
  9. OAR 407-120-0140: Trading Partner Agents as EDI Submitters — EDI Transactions
  10. OAR 407-120-0150: Testing — EDI Transactions
  11. OAR 407-120-0160: Conduct of Transactions — EDI Transactions
  12. OAR 407-120-0165: Pharmacy Point of Sale Access
  13. OAR 407-120-0170: Confidentiality and Security
  14. OAR 407-120-0180: Record Retention and Audit
  15. OAR 407-120-0190: Material Changes
  16. OAR 407-120-0200: Department System Administration
  17. OAR 407-120-0300: Definitions
  18. OAR 407-120-0310: Provider Requirements
  19. OAR 407-120-0320: Provider Enrollment
  20. OAR 407-120-0325: Compliance with Federal and State Statutes
  21. OAR 407-120-0330: Billing Procedures
  22. OAR 407-120-0340: Claim and PHP Encounter Submission
  23. OAR 407-120-0350: Payments and Overpayments
  24. OAR 407-120-0360: Consequences of Non-Compliance and Provider Sanctions
  25. OAR 407-120-0370: Requirements for Financial, Clinical, and Other Records
  26. OAR 407-120-0380: Fraud and Abuse
  27. OAR 407-120-0400: MMIS Replacement Communication Plan
  28. OAR 407-120-1505: Provider and Contractor Audits, Appeals, and Post Payment Recoveries