Personal Support Worker (PSW) Provider Enrollment Application and Agreement (Revised 08/01/2018)January 28th, 2022
FiledJanuary 28th, 2022This Provider Enrollment Application and Agreement (Agreement), sets forth the conditions and agreements for being enrolled as a Medicaid Personal Support Worker (Provider) with the State of Oregon Department of Human Services (DHS), Office of Developmental Disabilities Services (ODDS), and to receive a Provider number to receive payment for services furnished by the Provider to approved Medicaid eligible individuals (Recipients) in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementJuly 31st, 2018
FiledJuly 31st, 2018This Provider Enrollment Application and Agreement (Agreement), sets forth the conditions and agreements for being enrolled as a Medicaid Personal Support Worker (Provider) with the State of Oregon Department of Human Services (DHS), Office of Developmental Disabilities Services (ODDS), and to receive a Provider number to receive payment for services furnished by the Provider to approved Medicaid eligible individuals (Recipients) in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementJuly 31st, 2018
FiledJuly 31st, 2018This Provider Enrollment Application and Agreement (Agreement), sets forth the conditions and agreements for being enrolled as a Medicaid Personal Support Worker (Provider) with the State of Oregon Department of Human Services (DHS), Office of Developmental Disabilities Services (ODDS), and to receive a Provider number to receive payment for services furnished by the Provider to approved Medicaid eligible individuals (Recipients) in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementJuly 18th, 2018
FiledJuly 18th, 2018This Provider Enrollment Application and Agreement (Agreement), sets forth the conditions and agreements for being enrolled as a Medicaid Personal Support Worker (Provider) with the State of Oregon Department of Human Services (DHS), Office of Developmental Disabilities Services (ODDS), and to receive a Provider number to receive payment for services furnished by the Provider to approved Medicaid eligible individuals (Recipients) in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementAugust 16th, 2013
FiledAugust 16th, 2013This Provider Enrollment Application and Agreement (Agreement), sets forth the conditions and agreements for being enrolled as a Medicaid Personal Support Worker (Provider) with the State of Oregon Department of Human Services (DHS), Office of Developmental Disabilities Services (ODDS) and to receive a Provider number in order to receive payment for services furnished by the Provider to approved Medicaid eligible individuals (Recipients) in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementAugust 16th, 2013
FiledAugust 16th, 2013This Provider Enrollment Application and Agreement (Agreement), sets forth the conditions and agreements for being enrolled as a Medicaid Personal Support Worker (Provider) with the State of Oregon Department of Human Services (DHS), Office of Developmental Disabilities Services (ODDS) and to receive a Provider number in order to receive payment for services furnished by the Provider to approved Medicaid eligible individuals (Recipients) in Oregon. Payments for services are made using federal Medicaid and state funds.