OPRA Enrollment Information & Website

In order for Medicaid to pay on a claim, the ordering provider must be enrolled with Medicaid as an Ordering, Referring, Prescribing or Attending (OPRA) provider.

Most counties require that their SLPs (who are recommending/ordering) be OPRA enrolled so the services they provide will be Medicaid reimbursable.

Medicaid enrolled providers are due to revalidate every (5) five years from either the enrollment effective date, as specified in their Medicaid "Welcome Letter" or the last date revalidation was completed as indicated in their "Successful Completion of Revalidation Letter.

Have questions?

Contact the eMedNY Call Center 1-800-343-9000 -or-
Contact the McGuinness Medicaid Department 518-393-3635, Ext. 41.

eMEDNY CALL CENTER PHONE NUMBER & HELPFUL LINKS FOR OPRA

eMedNY Call Center Phone Number: 1-800-343-9000

Enrolled Practitioner's SEARCH PAGE: (To check your enrollment status) https://www.emedny.org/info/opra.aspx

Next Anticipated Revalidation Date (To check your revalidation status):
https://health.data.ny.gov/Health/Medicaid-Enrolled-Provider-Listing/keti-qx5t/data
Provider ENROLLMENT Screen - (Select Option #2)
(New Enrollment * Revalidation * Reinstatement/Reactivation): https://www.emedny.org/info/ProviderEnrollment/ther/index.aspx
Enrollment Form Instructions:
Complete ALL items on the form. Failure to complete all required fields will result in your enrollment form being returned to you, which may impact the enrollment effective date.
The signature field must be signed in black or blue ink and must be an original signature - stamps not accepted.
You must include a copy of your current license/registration along with the OPRA Enrollment Form.
**KEEP A COPY OF ALL DOCUMENTS SUBMITTED.**
If you were previously excluded/terminated from the Medicaid Program, complete the Prior Conduct Questionnaire found at: https://www.emedny.org/info/ProviderEnrollment/ProviderMaintForms/431001_PRIOR_COND_PriorConductQuest.pdf

REVALIDATION Information (Enrolled - Required to Revalidate): https://www.emedny.org/info/ProviderEnrollment/revalidation/index.aspx
- Revalidation Frequently Asked Questions:
- Once enrolled, how often do I need to revalidate? Every five (5) years (either from the enrollment effective date as specified in the Medicaid Welcome Letter or the last date revalidation was completed as indicated in the Successful Completion of Revalidation Letter).
- What happens if you don't Revalidate? Your enrollment will be terminated. This means that you will no longer be eligible to order/refer/prescribe services and payment for the services you provide cannot be billed to Medicaid.
- I received notice that my enrollment has been terminated because I did not revalidate. What do I need to do:
  - Complete the revalidation form for your provider type and mail to the eMedNY address.
  - Call 800-343-9000 7-10 days later to confirm receipt of your revalidation form.
  - Ask for a 9-digit Enrollment Tracking Number (ETN).
  - Write the provider mailbox at Providerenrollment@health.ny.gov and state that you have revalidated and wish to be reactivated. Provide your Enrollment Tracking Number.

Frequently Asked Questions (FAQs): https://www.emedny.org/info/ProviderEnrollment/ProviderMaintForms/Core_OPRA_FAQs.pdf

Article ID: 255, Created: 1/29/2021 at 11:40 AM, Modified: 1/5/2022 at 1:09 PM

OPRA Enrollment Information & Website

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