Ordering/Referring/Prescribing (ORP)

Ordering, Referring and Prescribing (ORP) is a claims submission requirement that is for all claims with a date of service of January 1^st, 2018 and after. The Office of Mental Health and Substance Abuse Services (OMHSAS) establishes the levels of care (Provider Type / Specialty) where ORP are required to support the billed services. For a complete list of all levels of care that require ORP, please access Document A.

**Any claim that does not include an active / eligible ORP practitioner on a claim are subject for denial, retraction and recoupment.

If you have any questions regarding your ORP compliance or need technical assistance on how to become compliant for this requirement, please contact your Network Management Specialist at:

Bucks/Montgomery:
(877) 769-9779

Cambria:
(800) 424-3711

Lehigh/Northampton:
(866) 780-3368

ORP Resources

• RCPA Memo – DHS guidance for ORP (December, 2017)
• DHS – Provider quick tips for ORP
• DHS website

ORP Training

• OMAP presentation (August, 2017)
• BH-MCO presentation materials (August, 2017)

 

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