SoonerRide

Lodging and/or Meals Services

If you must travel a long distance that requires an overnight stay in order to access SoonerCare approved medical services with a specialist doctor, then you can contact the Population Care Management Division at 877-252-6002 to request help with lodging and/or meals during your trip.

The Population Care Management Division will talk with you, review your request, and notify you whether or not you are approved for SoonerCare lodging and/or meals services.

You may also ask a hospital social worker to help you, or ask your doctor’s office to send a SoonerCare Lodging and/or Meals Request form (referral form) to Population Care Management Division. The form they need can be found below.

Expand the sections below for more information.

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. - Room and Board Providers (list of lodging providers)
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.
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 405-213-1145.

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.

For Extended Stays (submit referral at least 3 business days before the 14th day limit)

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.

Notes

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.

Must receive Title XIX benefits
All services are based on medical necessity.
All efforts to secure a temporary place to stay either by private insurance, the hospital, or a non-profit organization must be exhausted prior to seeking reimbursement for lodging and/or meals, as SoonerCare is the payer of last resort.
Lodging and/or meals services will only be reimbursed if the trip is for specialty care that is at least 50 miles from the member’s home, the trip cannot be completed during SoonerRide’s operating hours, and the trip lasts 18 hours or more.
The provider must make every attempt to schedule an appointment that will allow the member to travel the same day within SoonerRide operating hours.
If the member would need to commence travel before 4:30 a.m. to arrive at the appointment/procedure time, then the member is eligible for lodging the night before. If the member could not arrive home by 6:30 p.m. after the appointment/discharge time, then the member may be eligible for lodging that night.
Lodging and/or Meals assistance for next-day follow-up appointments including post procedure observation will be reviewed on a case by case basis.
Lodging and/or Meals cannot be reimbursed for travel done more than 24 hours before or after the medical service/order.

If the member is a child or an adult who’s health or disability does not permit traveling alone, then lodging and/or meals services for one medical escort may be requested.
The escort must be an adult at least age 18 and must be capable of assisting the member.
While the member is admitted inpatient at a treatment facility, Lodging and/or Meal assistance would only be allowable to a qualifying escort, not to the member. 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.
For children in OKDHS custody, the court-appointed guardian is eligible for lodging and/or meals services.

Check-in requirements may differ per lodging facility.
The member and/or escort are responsible for making reservation with the lodging provider and notifying the social worker to request additional days/nights of lodging and/or meals services.
The member and/or escort may be required to sign in/out at the lodging provider’s front desk on a daily basis.
The member and/or escort are responsible for notifying the lodging provider if they do not stay overnight; the lodging provider is not eligible for reimbursement if the member and/or escort do not stay overnight. If the member and/or escort do not remove personal belongings, the lodging provider may charge the member and/or escort for the room that is occupied.
It is the member’s and/or escort’s responsibility to inquire about the lodging provider’s policies. SoonerCare will not pay for any additional fees such as: fees for additional people in the room, over stay fees, lost keys/cards, phone bills (local or long distance), upgrades or extra/additional amenities for the room, lost or stolen items, or damages to facility property.

SoonerRide

Lodging and/or Meals Services

Guidelines For Making A Referral

Guidelines for Determining Eligibility

Guidelines For Determining A Qualified Medical Escort

Hospital Social Workers Must Inform The Member

Resources