Guidelines For Making A Referral

All out of state referrals require prior medical review.
If the treatment facility where the member is inpatient allows one person to stay overnight in the member’s room then overnight lodging is not authorized.
Hospital Social Workers may continue to issue lodging and/or meals vouchers up to 14 days per medical stay (verification with member is required regarding number of days that they have been receiving lodging and /or meals services).
Lodging &/or Meals Voucher may be discontinued at any time if criteria for visitation is not met.
Lodging and/or Meals Authorization form (voucher)
Room and Board Providers (list of lodging providers)
If lodging and/or meals services are needed beyond 14 days per medical stay, a referral must be submitted to OHCA Population Care Management for review.
When submitting documents for a lodging and/or meals referral, documents are to be faxed for review 3 business days before the date lodging and/or meals services are needed; fax to OHCA Population Care Management – Attention: Social Services at 405-530-3217.

For Initial Referrals

Fax a completed SoonerCare Lodging &/or Meals Request form or member’s proof of appointment.
SoonerCare Lodging and/or Meals Request Form (referral form).
Proof of appointment must include the member’s name, phone number and SoonerCare ID number; the date, check in time, and duration of the appointment or procedure.

Fax an updated letter of medical necessity or the member’s most recent nursing progress notes/medical records. Include the anticipated length of stay.
Notify Care Management by phone or fax of the dates that the escort is requesting lodging and/or meals services, and how many days have already been approved for the member or escort.
For NICU, the escort’s visitation log showing sign in/out times is required. Visitation MUST total a minimum of 6 hours per day to be eligible for continued lodging and/or meals services.

Meals will be reimbursed only if meets the lodging criteria and the duration of the trip was 18 hours or more.
If the member and/or escort meets the criteria for lodging services and stays overnight, but does not request SoonerCare assistance for lodging, then the member and/or escort may still be eligible for meals assistance/reimbursement.
The member and/or escort are not eligible for reimbursement for meals if the lodging provider submits a claim for meal reimbursement because they are providing meals to the member.

Last Modified on Jul 06, 2023