ORR-FUNDED MEDICAL ASSISTANCE
OFMA RESOURCES
This website contains all of USCRI’s OFMA materials. All new documents and updated versions will be uploaded to this page. We have included links to some of the material on Point Comfort Underwriters’ RMA & OFMA Resource Portal, but note that additional material can be found there (https://rma.pointcomfort.com/)
FORMS
PCU Provider Request Form
See the Single Case Agreement Guidance under the Informationals section for more information on this form.
OFMA Annual Reverification Form
To annually reverify that the youth is still eligible for OFMA benefits and continues to give permission to authorize the release of their information to both USCRI and the URM/URD. Additionally this form reverifies that the URM will continue to act as their authorized representative regarding their OFMA benefits.
Release Authorization Form
Authorizes the URM agency and USCRI to receive and review the youth's Private Health Information (PHI) and Personal Identifying Information (PII). This authorization covers all medical treatment and claims processing and payment relating to covered individual.
BENEFITS
DenteMax Letter
This letter informs the contracted DenteMax provider that PCU members are in network.
Support Services Informational
This informational can be provided to OFMA enrollees to inform them of the Support Services that USCRI offers under their OFMA coverage.
OFMA Support Services Wallet Card
This wallet card informs clients who they can call with questions or requests regarding OFMA Support Services.
INFORMATIONALS
OFMA Eligibility Guidance