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Oklahoma Medicaid
Oklahoma Medicaid, a contract on file and paid
An approved SoonerCare contract, a provider number in hand, and renewals finished before the contract expires.
Oklahoma Medicaid enrollment pays off when the contract is approved and on file, because providers must have an approved contract on file with OHCA to be eligible for payment. Applications start on the SoonerCare Provider Enrollment page.
Contract required
To be eligible for payment, providers must have an approved contract on file with OHCA. OHCA, SoonerCare Provider Contracts training
Hold claims
OHCA says to hold claims until you receive a provider number. OHCA, Enrollment FAQs and Terms
Renewal window
The contract renewal period opens 75 days before the expiration date, and OHCA strongly encourages early renewal. OHCA, SoonerCare Provider Contracts training
Saved applications expire
A saved online application must be submitted within 35 days of the last save, or the information is lost. OHCA, SoonerCare Provider Enrollment
What we see in practice
45 to 90 days from submission to an active Medicaid ID.
In the official words
To provide health care services to SoonerCare members and to be eligible for payment, providers must have an approved contract on file with OHCA.
An individual provider must complete an enrollment application for each physical location in which he or she practices.
A contract on file is what gets claims paid
SoonerCare is a collection of Oklahoma health care benefit packages that includes fee for service Medicaid, and OHCA requires providers to have an approved contract on file to be eligible for payment. OHCA Until the provider number arrives, OHCA says to hold claims. OHCA
New providers leave the provider number blank, and OHCA assigns and enters it when the application is processed. OHCA then notifies you of the number by two emails, a Welcome Letter and a Pin Letter, sent using the information entered on the application. OHCA
How enrollment works, step by step
- First time applicants complete the online enrollment application and sign the provider contract in it. OHCA
- You may need to upload supporting documentation to OHCA. What is needed depends on your provider type, and a list of required documents is displayed once you begin. OHCA
- Finish inside the save window. A saved application must be submitted within 35 days of the last save, or the information is lost and you start again. OHCA
- Apply the group rule. A group fills out an application, and each individual in the group completes an individual application as well. An individual provider needs an application for each physical location where he or she practices. OHCA
- Watch the email address on the application. If an application is returned for corrections, the notices go to the enrollment contact submitted on it. OHCA
In Oklahoma the pace is set by what you do with each notice. A saved application is lost after 35 days, and a returned application gets a reminder after 15 days and an expiry notice after 30. In our experience an Oklahoma file runs 45 to 90 days from submission to an active Medicaid ID, and a group adds to it by needing an application for every individual in it.
Site visits and contract renewal
Federal rules require some providers to have onsite screening visits. These visits may be conducted without prior notification or by appointment, and failing to cooperate with the OHCA representative could affect the provider's enrollment. OHCA
Contracts expire according to provider type. The renewal period opens 75 days before the expiration date, with an email to the official contact at 75 days and a reminder at 45 days. OHCA
Keep the provider file current. OHCA asks every contracted provider to keep it up to date, including email addresses, phone numbers and locations, so that OHCA communications reach you. OHCA
Where Oklahoma enrollments lose money
The first loss is the application that sits. If an application is returned for corrections, email notifications go to the enrollment contact. The first email says corrections are needed, a reminder follows 15 days after it, and 30 days after it comes a notice that the contract has expired and a new application is required. OHCA
The second is a renewal that never finishes. A provider who began renewal but did not complete it before the contract expired needs a new contract, and a renewal returned for errors must be corrected before the expiration date or a new contract may be required. OHCA
The third is a saved application left alone. After 35 days from the last save, the information is lost and you have to start again. OHCA
Check where you stand before you submit
WeBill Health runs Revenue Velocity Credentialing with 24/7 CAQH and PECOS lifecycle monitoring, so revalidation dates and affiliation gaps are caught before they become suspended claims. Every file gets Human Expert Review from a credentialing specialist before it goes to the state.
Revenue Velocity Credentialing
WeBill Health manages the full payer enrollment lifecycle, so your revenue cycle starts the moment your practice does.
Up to 40%
less payer enrollment lag against the industry baseline
24/7
CAQH and PECOS lifecycle monitoring
Review your enrollment status with us
The Revenue Defense Audit is a free, forensic review of your claims and A/R by the team that would work your account, including providers seeing patients under a payer that cannot pay them yet.
Want a quick read first? Check my Revenue Defense Score for the credentialing and denial exposure in your specialty.
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