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.