1. (1) If a hospital has been given incorrect information by the Division of Medical Assistance Programs, or Children, Adults, and Families Programs, or Aging and People with Disabilities/staff, and services were provided on the basis of this information, and payment has been denied as a result, the hospital may submit a request for payment as an administrative error.

2. (2) Include the following:

   1. (a) An explanation of the problem;
   2. (b) Any documents supporting the request for payment;
   3. (c) A copy of any paper remittance advice or electronic 835 printouts received on this claim;
   4. (d) A copy of the original claim.
3. (3) Send the request: Division of Medical Assistance Programs, Provider Inquiry, Administrative Errors, 500 Summer Street NE, E-44, Salem, OR 97301-1077.

Statutory/Other Authority

ORS 413.042

Statutes/Other Implemented

ORS 414.065

History

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 21-1990, f. & cert. ef. 7-9-90, Renumbered from 461-015-0730
AFS 72-1989, f. & cert. ef. 12-1-89
AFS 49-1989(Temp), f. 8-24-89, cert. ef. 9-1-89