Provider Forms & Documents
Billing
This page provides all forms and documentation for providers billing UOVC, including treatment plans, dental forms, billing forms, and payment setup.
Mental Health Treatment Plans
Common Billing Forms
CMS-1500 Billing Form
UB-04 Billing Form
ADA Dental Claim Form
Fast Track Reimbursement Form – SA Services Providers
Receiving Payment / Vendor Setup
New vendors (never paid by the state) → New Vendor FI-170 + W-9
All vendors setting up Direct Deposit/EFT → EFT FI-171