Common Contracts
9 similar Provider Enrollment Application and Agreement contracts
Personal Support Worker (PSW) Provider Enrollment Application and Agreement (Revised 08/01/2018)Provider Enrollment Application and Agreement • January 28th, 2022
This 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 AgreementProvider Enrollment Application and Agreement • July 31st, 2018
This 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 AgreementProvider Enrollment Application and Agreement • July 31st, 2018
This 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 AgreementProvider Enrollment Application and Agreement • July 18th, 2018
This 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 AgreementProvider Enrollment Application and Agreement • July 18th, 2018
This 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 AgreementProvider Enrollment Application and Agreement • March 8th, 2017
This 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 AgreementProvider Enrollment Application and Agreement • February 22nd, 2017
This 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 AgreementProvider Enrollment Application and Agreement • August 16th, 2013
This 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 AgreementProvider Enrollment Application and Agreement • August 16th, 2013
This 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.
