Ordering, Prescribing or Referring Providers
For Medicaid to reimburse for services or medical supplies
resulting from a practitioner's order, prescription, or referral,
the ordering, prescribing, or referring (OPR) provider must be
enrolled in Medicaid. OPR providers do not bill IHCP for services
rendered but may order, prescribe, or refer services/supplies for
IHCP members. Enrolling as an OPR provider is appropriate for
practitioners who:
- May occasionally see an individual who is an IHCP member who
needs additional services or supplies that will be covered by the
Medicaid program
- Do not want to be enrolled as another IHCP provider type
- Do not plan to submit claims to the IHCP for payment of
services rendered
Participate in the IHCP as an OPR Provider
Interested practitioners and existing OPR providers should refer
to the Participating as an OPR
Provider page for detailed information on enrollment and other
transactions.
Directory of OPR Providers
IHCP providers who render services or supplies should use the Ordering, Prescribing
and Referring (OPR) Provider Search to verify IHCP enrollment
of the ordering, prescribing, or referring practitioner, before
services or supplies are provided.