Common Contracts
3 similar Enrollment Application and Agreement contracts
Provider Enrollment Application and AgreementEnrollment Application and Agreement • March 9th, 2015
This Provider Enrollment Application and Agreement “Agreement,” sets forth the conditions and agreements for being enrolled as a 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 service recipients in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementEnrollment Application and Agreement • August 30th, 2013
This Provider Enrollment Application and Agreement “Agreement,” sets forth the conditions and agreements for being enrolled as a 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 service recipients in Oregon. Payments for services are made using federal Medicaid and state funds.
Provider Enrollment Application and AgreementEnrollment Application and Agreement • July 11th, 2013
This Provider Enrollment Application and Agreement “Agreement,” sets forth the conditions and agreements for being enrolled as a 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 service recipients in Oregon. Payments for services are made using federal Medicaid and state funds.
