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Get Ohp 3113 Form 2024

E: Check only one box and fax to the number shown. Use a new coversheet for each transaction. Provider Enrollment (PE) - 503-378-3074 Claim Documentation - 503-378-3086 Prior Authorization (PA) For PA requests, also check one box below: Routine Processing - 503-378-5814 Urgent Processing (72 hours) 503-378-3435 Immediate Processing (24 hours) Hearing Documentation (no central fax #) Grievance Documentation (no central fax #) Correspondence - 503-378-3086 Justification and additional document.

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