Adjustments to Paid Claims
After review of both the claim and the Explanation of Benefits (EOB) Remittance Advice Report, a provider may determine that a claim needs to be adjusted. Providers may file adjustment requests to:
- Correct billing or processing errors.
- Correct inappropriate payments (overpayments and underpayments).
- Supply additional information that may affect the amount of reimbursement.
Adjustments are classified in two separate categories, check-related (refund) or non-check related, and further categorized as full or partial. Refer to Chapter 9 of the Provider Billing Manual for more information.
Providers may initiate reconsideration of a paid claim by submitting an appropriate Adjustment Request Form to Oklahoma Medicaid.
Telephone request for adjustments are not allowed due to federal and state rules. For additional information or questions please Contact Us 1-800-522-0114, option 3, sub-option 1. Monday, Wednesday thru Friday 7:30 a.m. - 4:00 p.m., Tuesday 12:00 p.m. - 4:00 p.m.
Refunding or returning money
Refund checks must be written to the order of:
Oklahoma Health Care Authority
OHCA Finance Unit
P.O. Box 18299
Oklahoma City, OK 73154