- (1) Most overpayment and under-payments are resolved through the adjustment process. Only paid claims can be adjusted. If no payment was made, the claim must be submitted using a CMS 1450 (UB-04) for processing. All overpayments must be reported. Overpayments will be taken from future payments.
- (2) Much of the information required on the Adjustment Request Form is printed on the paper Remittance Advice or the electronic 835. Documentation may be submitted to support the request. Attach a copy of the claim and paper Remittance Advice or the electronic 835 to the Adjustment Request (Division 1036). Adjustment requests must be submitted in writing to the Division of Medical Assistance Programs (Division).
(3) Complete adjustment instructions can be found in Hospital Services Supplemental Information.
[Publications: Publications referenced are available from the agency.]
Statutory/Other Authority
ORS 413.042
Statutes/Other Implemented
ORS 414.065
History
DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08
DMAP 19-2008, f. 6-13-08, cert. ef. 7-1-08
OMAP 17-2006, f. 6-12-06, cert. ef. 7-1-06
OMAP 70-2004, f. 9-15-04, cert. ef. 10-1-04
HR 42-1991, f. & cert. ef. 10-1-91
HR 2-1991, f. & cert. ef 1-4-91
HR 31-1990(Temp), f. & cert. ef. 9-11-90
HR 21-1990, f. & cert. ef. 7-9-90, Renumbered from 461-015-0510
AFS 72-1989, f. & cert. ef. 12-1-89
AFS 49-1989(Temp), f. 8-24-89, cert. ef. 9-1-89