Oklahoma Ranks Top in Nation for SoonerCare Application Processing Time

Oklahoma City, OK – A new report from the U.S. Centers for Medicare and Medicaid Services (CMS) ranks Oklahoma as the top state in the nation for Medicaid application and eligibility processing speed. According to the report, Oklahoma was the only state to process and conduct 100% of applications in less than 24 hours during the first three months of 2022. The Oklahoma Health Care Authority processed nearly 59,000 applications during the reported timeframe.

“It is vital for Oklahomans to quickly know if they are approved for SoonerCare benefits or if they need to submit more information to become approved,” said Kevin Corbett, Secretary of Health and Mental Health and OHCA Chief Executive Officer. “Not only does this benefit Oklahomans, but it is also fiscally responsible. Instead of our staff spending significant time working to determine if a member is eligible, staff can focus on educating new SoonerCare members on their benefits moving them to a healthier lifestyle.”

The report analyzes the length of time it took state Medicaid and Children’s Health Insurance Program (CHIP) agencies to conduct final determinations for individuals who submitted applications during January through March 2022.

OHCA includes processing time data as part of the agency’s monthly Medicaid and CHIP Performance Indicator report to CMS. Processing time data does not reflect the state’s volume of pending applications

SoonerCare applications are processed by running the application through several eligibility requirements and information exchanges built into the electronic application. Then, the application instantly provides a decision if the applicant is eligible or needs to submit more information. The application, eligibility rules and verifications are built in-house by OHCA and supported by Gainwell Technologies. During the application process and throughout the members eligibility, OHCA performs a system of checks, data exchanges, and audits to ensure reported eligibility information is accurate and updated as needed.

“We are proud to offer a real-time eligibility decision for Oklahomans applying for SoonerCare,” said Brandon Keppner, Chief Operating Officer. “The peace-of-mind it gives members to know they have health care coverage and can see a provider is important to OHCA’s mission to providing access to quality health care.”

Read the full CMS report here.