Pharmacy Claims Processing System

The Oklahoma Health Care Authority implemented a new claims processing system in April 2001. The new system supports NCPDP v3.2 and v5.0 and allows the agency to be more flexible and responsive to changes in the pharmaceutical market place. The new system architecture should minimize down time and has an enhanced compounding component that provides on-line processing of multi-ingredient compounds for pharmacies using NCPDP v.5.0.

In addition to the new claims processing system, OHCA will implement a new on-line Prospective Drug Utilization Review (ProDUR) system. The ProDUR system will help provide high quality care to Medicaid recipients by alerting you of potential drug interactions, duplicate therapies, etc., that can occur when a patient uses more than one pharmacy and one physician.

Last Modified on Nov 10, 2020

Oklahoma Health Care Authority

4345 N Lincoln Blvd

Oklahoma City, OK 73105

The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.