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DMAP administrative rules and other information for:

Targeted Case Management Services program

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Rulebook

February 3, 2010 (correction only-replaced OARs 410-138-0300, 410-138-0360 and 410-138-0380) (pdf) (Current administrative rules. See below for archived rules.)

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Supplemental information

TCM Billing Codes and Rates - Updated 1/6/2010

Medicaid/SCHIP Local Match Leveraging Form (PDF) - Updated July 2009 - To receive timely payment for claims, the unit of government provider must submit a prepayment at the local match rate, so that DHS can match the prepayment to the correct claims. This form is also available in Word.

• DHS must receive the payment and completed form by Wednesday, 5 p.m. of the week you submit the claim(s). Otherwise, the claim(s) will suspend until prepayment is received.
• Make sure the form and prepayment clearly identify the match amount(s) to associate with each provider number listed on the form.

How to read the paper remittance advice (PDF) - To find out what you owe for local match prepayment, review the "Leverage Claims Payable - Not Paid" section of the paper RA.

• “Remaining cash balance” (upper-left section of Leverage Claims Payable - Not Paid page) lists how much money you have left to prepay claims for the provider number listed in the “Payee ID” field.
• The Amount Total for “State Share Due” (bottom-right section of Leverage Claims Payable - Not Paid page) lists how much money you need to submit to DHS as a prepayment in order for DHS to pay the claim(s) listed.

Local match rates

The prepayment amount is a percentage of the total amount paid for claims submitted. The percentage is determined by the local match rate. Use the rates listed below, based on the claim's payment date.

Who to call for help

Provider Services 800-336-6016 or e-mail us
Address and telephone contacts

Other information

See also: Rulebook (administrative rules) & guide archive

See also: Notices: proposed rule revisions & hearings for this program

See also: Babies First! Web site

See also: CaCoon Web site

See also: Health Services Integration

See also: Tools for providers

If you have questions about DHS or problems getting DHS services, e-mail us: DHS Information. DHS GroupWise users, address e-mail to dhs.info@state.or.us. For comments on this site: DMAP Information. DHS GroupWise users, address e-mail to dmap.info@state.or.us

Oregon Department of Human Services
Division of Medical Assistance Programs
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