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Form OHP3120 Provider Enrollment Attachment - School Medical - Oregon
What Is Form OHP3120?
This is a legal form that was released by the Oregon Health Authority - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the OHP3120 Provider Enrollment Attachment?A: OHP3120 is a form used for provider enrollment attachment specifically for school medical services in Oregon.
Q: Who needs to fill out the OHP3120 form?A: Healthcare providers offering school medical services in Oregon need to fill out this form.
Q: What information is required on the OHP3120 form?A: The form requires information such as provider details, service location, billing information, and agreement to comply with program requirements.
Q: Is there a fee for submitting the OHP3120 form?A: No, there is no fee for submitting the OHP3120 form for provider enrollment attachment.
Form Details:
- Released on June 1, 2018;
- The latest edition provided by the Oregon Health Authority;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form OHP3120 by clicking the link below or browse more documents and templates provided by the Oregon Health Authority.
Download Form OHP3120 Provider Enrollment Attachment - School Medical - Oregon
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