Ordering/Referring/ Prescribing (ORP)
Ordering, referring and prescribing is an initiative to comply with program integrity provisions of the Affordable Care Act (ACA) which states that the State Medicaid agency must require all ordering or referring physicians or other professionals providing services under the State plan to enroll as participating providers effective January 1, 2018.
To ensure your compliance and ensure that your services are eligible for reimbursement please review the below documents that provide guidance on where to include ORP information on different types of claim forms. Document A outlines the state Provider Types (PT) and Specialty Codes (SP) that require ORP information on claims starting January 1, 2018. After your PT and SP is determined, please visit the State website for corresponding billing instructions.
Providers who need to enroll should visit – www.dhs.pa.gov/provider/promise/enrollmentinformation/index.htm