Global Messages

Last Modified on Feb 25, 2021

Posted Date	Subject	Message
12/20/2011	CDC Provider Enrollment	Title: CDC Provider Enrollment Run Dates:12/20/2011 – 02/05/2012 PV Type: 11, 53 Spc: 110, 112, 121, 585, 115, 535, 536 Attention Behavioral Health Providers – CDC Provider Enrollment In a letter dated 11/30/2011 from Mike Fogarty, CEO of the Oklahoma Health Care Authority, you were notified of the temporary lifting of prior authorizations for outpatient behavioral health, the termination of the Optum contract, and the Client Data Core (CDC) would be required to be submitted as a condition of payment. In preparation for submitting the CDCs, you will be receiving a letter from The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) in the next day or two. The letter from ODMHSAS is to guide you through the first part of the process to begin submitting CDCs again. The letter has information which is specific to each provider, so you must have it before you begin. If you do not receive this letter by 12/28/2011, you may contact gethelp@odmhsas.org. This first step is to enroll the provider, then to ask which specific staff will need access to CDC data entry and access to reports. Not every staff member may need to be enrolled, just those who need access to the system. The process to enroll the provider and add 10 staff should take about 5 minutes. Within a day or two of enrolling staff members, they will receive an email notification asking them to enroll. If you would like to participate in an optional, 15 minute webinar, which will review this step in the process, please go to http://www.odmhsas.org/cdc_initial_provider_enrollment.htm to sign up. Letter example: http://www.odmhsas.org/ProvEnrollExample.pdf Where letter is being sent: http://www.odmhsas.org/ProvEnrollList.pdf We look forward to working with you.
12/20/2011	278 Prior Authorization Request/Response Companion Guide Document Now Available	RE: 278 Prior Authorization Request/Response Companion Guide Document Now Available The 278 Companion Guide document is now available. Please refer to the 278 Companion Guide Document and make any necessary changes to your system to request prior authorizations via this ASC X12 5010 format. Requesting prior authorizations via this transaction is NOT required by the OHCA and providers may continue using the existing process to request prior authorizations. All 5010 Companion Guide documents are located at: 5010 Companion Guides and NCPDP D.0 Payer Sheet.
Attention: Electronic 276 submitters: Updated 5010 Companion Guide Documents Available Updates have been made to the 276/277 Companion Guide Document. E2 has been removed from the transaction identifiers at GS08 and ST03 segments. Please refer to the updated 276/277 Companion Guide Document and make any necessary changes to your system. The ASC X12 5010 transactions will be the standard format beginning 01/01/2012. All 5010 Companion Guide documents are located at: 5010 Companion Guides and NCPDP D.0 Payer Sheet.
12/20/2011	Electronic 270 submitters: Updated 5010 Companion Guide Documents Available	Attention: Electronic 270 submitters: Updated 5010 Companion Guide Documents Available Updates have been made to the 270/271 Companion Guide Document regarding proper placement of data in the ISA06 and ISA08 segments. Please refer to the updated 270/271 Companion Guide Document and make any necessary changes to your system. The ASC X12 5010 transactions will be the standard format beginning 01/01/2012. All 5010 Companion Guide documents are located at: 5010 Companion Guides and NCPDP D.0 Payer Sheet.
12/20/2011	Electronic 837P and 837D submitters: Updated 5010 Companion Guide Documents Available	Attention: Electronic 837P and 837D submitters: Updated 5010 Companion Guide Documents Available Updates have been made to the 837P and 837D Companion Guide Documents regarding proper placement of the Rendering Provider ZIP+4 on these two transactions. The ZIP+4 is necessary in some cases to crosswalk the NPI of rendering providers with more than one service location. The 5010 837P and 837D Technical Reports have been interpreted such that the REF Rendering Provider Secondary Information segment at both the header and detail segment cannot be used with an NPI in the NM109 element of the same loop. As a result, OHCA is requiring the Rendering Provider's ZIP+4 information in the 5010 transactions to be entered in the NTE segment at the header and/or detail level on the 837P, and at the header level on the 837D. Please refer to the updated 837P and 837D Companion Guide Documents and make any necessary changes to your system. The ASC X12 5010 transactions will be the standard format beginning 01/01/2012. All 5010 Companion Guide documents are located at: 5010 Companion Guides and NCPDP D.0 Payer Sheet.
12/14/2011	PSYCH Testing	Title: PSYCH Testing Run Date: 12/12/2011 – 01/27/2012 PV Type: 11, 53 Spc: 110, 112, 121, 115, 535, 536, 585 Dear Behavioral Health Provider, Beginning December 13, 2011 you can call OHCA to determine if a member had had previous testing within the last year. Call 405-522-7861. OHCA staff will be able to assist. If you need to leave a message, we will call back as soon as possible. If you have any questions Please call the OHCA call center at 1-800-522-0114.
12/13/2011	5010 Conference Call hosted by HP Enterprise SVS	Title: 5010 Conference Call hosted by HP Enterprise SVS Run Dates: 12/13/2011 – 12/17/2011 Pv Types: All Target Audience: EDI batch file submitters HP Enterprise Services will host a 5010 conference call on Friday, December 16th from 1:30 - 2:30 central time. The following topics will be discussed: - 5010 testing update - Common 5010 errors - Companion Guide updates - SoonerCare specific changes for 5010 (CN1) - 5010 Testing Request Form - Announcement of NCPDP D.0 “go live” date - Other news and announcements - Questions/Answers All SoonerCare EDI submitters, billing agents, clearinghouses, VANS, and software vendors are welcome to attend this teleconference. Please contact the EDI Helpdesk with any questions at (405) 522-0114, option 2, 2. Date: Friday December 16, 2011 Time: 1:30 - 2:30 central time. Conference dial in number: 866-409-2889 Conference Code: 4931653160
12/12/2011	PSYCH Testing Run Date: 12/12/2011 – 01/27/2012	Title: PSYCH Testing Run Date: 12/12/2011 – 01/27/2012 PV Type: 11, 53 Spc: 110, 112, 121, 115, 535, 536, 585 Dear Behavioral Health Provider, Beginning December 13, 2011 you can call OHCA to determine if a member had had previous testing within the last year. Call 405-522-7861. OHCA staff will be able to assist. If you need to leave a message, we will call back as soon as possible. If you have any questions Please call the OHCA call center at 1-405-522-0114.
12/12/2011	Electronically Submitted Claims Only 4010 to 5010 Cutover Schedule – Extended Maintenance Period	Title: Electronically Submitted Claims Only 4010 to 5010 Cutover Schedule – Extended Maintenance Period Run Dates: 12/12/2011 – 01/27/2012 PV Types: All 4010 To 5010 Cutover Schedule – Extended Maintenance Period for Electronically Submitted Claims Only: • OKMMIS will be down from Saturday December 31, 2011 at 6:00 p.m. until Sunday, January 1, 2012 at 5:00 a.m. • Effective Saturday, December 31, 2011 at 6:00 p.m., all EDI claims submissions must be in ASCX12 5010 format. Please refer to the Banner Messages listed on the OHCA Public Website for additional information.
12/8/2011	UPDATE from Conference Calls: BH PA, CDC Process	Title: UPDATE from Conference Calls: BH PA, CDC Process Run Date: 12/08/2011 – 01/23/2012 PV Type: 11, 53, Spc: 110, 112, 121, 115, 535, 536, 585 Dear Outpatient Provider, This information follows the first scheduled conference call hosted by ODMHSAS and OHCA regarding questions about the changes in the authorization/CDC process. Below are websites [that were referenced in the conference calls of December 6th & 7th, 2011] where forms and information related to CDC submission are available to you. www.odmhsas.org/arc.htm (DMH providers) www.Odmhsas.org/arc2.htm (Non DMH providers)
12/7/2011	CPAP Authorization Guideline Revisions	Title: CPAP Authorization Guideline Revisions Run Date: 12/08/2011 – 01/31/2012 PV Types: 250 DME Providers Effective January 1, 2012, OHCA will implement new CPAP Authorization guidelines to align with CMS LCD # L11518 (Revised 10/1/2011). Interpreting Physicians must be board-certified in sleep medicine; Sleep diagnostic testing facilities must be accredited and follow state law; Home Sleep Studies are NOT COVERED by OHCA; Providers must show evidence of adherence to therapy for all members (not just those with AHI under 15) beyond the first three months of therapy; Clinical benefit is demonstrated by face-to-face clinical re-evaluation by the treating physician with documentation that symptoms of OSA are improved; and, objective evidence of adherence to therapy is use of PAP greater than or equal to 4 hours per night on 70% of nights during a consecutive thirty (30) day period during the first three (3) months of initial usage - from LCD OHCA will offer a purchase option for members who qualify for continuation – see DME website for instructions.
12/7/2011	Ultrasound Benefit Clarification re: Provider Letter 2011-54	Title: Ultrasound Benefit Clarification re: Provider Letter 2011-54 Run Date: 12/07/2011 – 01/25/2012 PV Types: 31 – Physician 091 – OB Nurse Practitioner 181 – Maternity 214 – High Risk Pregnant Women 316 – Family Practitioner 318 – GP 323 - Neonatologist 328 – OB/GYN 335 – Maternal Fetal Medicine In our recent Provider Letter 2011-54 sent last week, the portion in brackets below is not accurate. MFM alone or with the member’s chosen obstetric provider coordinate care and they will determine where the additional ultrasounds need to be performed. We apologize for any confusion this might have caused. Women deemed high-risk, based on criteria established by the OHCA, may receive prior authorization for medically necessary enhanced benefits, which include six additional ultrasounds, [which must also be performed by an MFM]. Women who have a high-risk pregnancy can be cared for by a board certified diplomat in Maternal Fetal Medicine alone or along with her chosen obstetric provider. The CPT Codes for high risk ultrasounds are 76815, 76816 and 76817 and are only compensable for women deemed high risk by OHCA.
12/5/2011	Conference Calls: BH PA, CDC Process	Title: Conference Calls: BH PA, CDC Process Run Date: 12/05/2011 – 01/20/2012 PV Type: 11, 53 Spc: 110, 112, 121, 585, 115, 535, 583, 536 Dear Outpatient Provider, ODMHSAS, along with OHCA, will be hosting several conference calls to answer your questions about the changes in the authorization/CDC process. We have set aside the following times for your convenience. Tuesday, December 6th @ 3:30 pm Wednesday, December 7th @ 2:00 pm • There is no need to be on both calls. The information will be repeated. • We can only host the first 100 callers so if you are unable to get on the first call, please try to get on the second call. • If there are multiple individuals in a single location, please try to call from a single phone. • *6 is the mute key. Please use the following number and access code: 1-877-402-9757 access code: 9899630#
11/30/2011	TENS UNIT – PA Requirement Removed	Title: TENS UNIT – PA Requirement Removed Run Date: 11/30/2011 - 01/31/2012 PV Types: 250 – DME/Medical Supply Dealers Please be advised that effective January 1, 2012, OHCA will implement a change for TENS units. NO Prior Authorization will be required for HCPCS codes E0720 and E0730. E0720 – Transcutaneous electric nerve stimulation (TENS) device, 2 lead, localized stimulation. E0730 – Transcutaneous electric nerve stimulation (TENS) device, 4 or more leads, for multiple nerve stimulation. A physician signed copy of the HCA-39 (CMN for TENS devices) must be kept on file at the provider’s location showing evidence of a 30 day trial and follow-up by the physician prior to billing. The HCA-39 must be kept on file at the provider’s location in case of an audit. Contact Stan Ruffner at stan.ruffner@okhca.org with questions.
11/17/2011	Online-Generated Letters (Expirations)	Title: Online-Generated Letters (Expirations) PV Types: All Run Date: 11/17/2011 - Indefinite OHCA is GOING GREEN! Look for upcoming notifications via email. If we do not have your email, please notify us at www.okhca.org or call OHCA Provider Contracts at (800)522-0114 Option #5. If you do not retrieve this information within 14 days, you receive a paper letter via the US postal service. Thank you for your support of the OHCA’s green effort!
11/16/2011	5010 Testing Request Form	Title: 5010 Testing Request Form PV Types: All Run Date: 11/15/2011 – 01/01/2012 OHCA and HP will soon open up 5010 testing for all current trading partners. If you have not done so already please submit a 5010 Testing Request form. This electronic form is located on the OHCA website at www.okhca.org/edi. When you submit this form we will be able to convert your current trading partner agreements to the appropriate agreements for version 5010 HIPAA compliance testing purposes. If you choose not to submit the form we will be unable to test with your organization. Please contact the EDI Helpdesk with any questions at (800) 522-0114, option 2, 2.
11/16/2011	H2017 Billed with HW Modifier	Title: H2017 Billed with HW Modifier Run Date: 11/15/2011 – 01/01/2012 PV Types: 11, Spc: 111, 118 For DOS after 10/1/2011 when billing H2017 the HW modifier must be in the 3rd position. If you have claims that have paid incorrectly, please void that claim and bill them according to the following sequence H2017 HE/HV/HH/HF, HQ, HW to get the appropriate rate.
11/14/2011	BH – H2017 Billings for DOS after 10/01/2011	Title: BH – H2017 Billings for DOS after 10/01/2011 Run Date: 11/14/2011 – 12/31/2011 PV Types: 110 – Outpatient Mental Health Clinic, 111 – Community Mental Health Center (CMHC), 118 – Mental Health/DMHSAS There was a slight glitch in the claims file related to H2017 billings for DOS after 10/1/2011. It was not allowing the appropriate group therapy units to be billed. This was corrected over the weekend. You can resubmit these claims for reprocessing. Remember to void your original claim so the system will not deny as a duplicate submission. Thank you.
11/14/2011	5010 Conference Call & Webinar hosted by HP Enterprise Services	5010 Conference Call & Webinar hosted by HP Enterprise Services Target Audience: EDI batch file submitters Marvin Dale IN CASE YOU MISSED IT! 5010 Conference Call & Webinar hosted by HP Enterprise Services Target Audience: EDI batch file submitters HP Enterprise Services will host a 5010 Webinar on Friday, November 18th from 1:30 – 2:30 central time. The following topics will be discussed: 5010 testing update; 5010 Overview; The SoonerCare Approach to 5010 Implementation; Tips for Passing Compliance; NCPDP D.0; NPI Crosswalk for 5010 ; What’s New: Secure Site Changes, New EDI Transaction; Q&A All SoonerCare EDI submitters, billing agents, clearinghouses, VANS, and software vendors that are familiar with loops and segments of the current 4010 requirements are welcome to attend this webinar event. Future 5010 teleconferences and webinar events will also be offered, dates and times to be determined. Date: Friday November 18, 2011 Time: 1:30 -2:30 central time. 1. View the presentation by clicking the following link and entering your name AND the participant key below: https://www.rooms.hp.com/attend/default.aspx?key=EP2BVB4WXE Participant key: EP2BVB4WXE 2. Listen to the presentation by dialing the following number and entering the conference pin code: Conference dial in number: 866-409-2889 Conference Code: 4931653160 Please contact the EDI Helpdesk with any questions at (405) 522-0114, option 2, 2.
11/4/2011	Speech Therapy when English is not the Primary Language	Title: Speech Therapy when English is not the Primary Language Run Date: 11/04/2011 - 12/19/2011 PV Types: 173 – Speech/Hearing Therapist, 182 – Speech/Hearing Clinic Effective immediately: All speech therapy requests for children who are bilingual or for whom English is not the primary language must include the following information in the evaluation report: Primary language; The language that testing was conducted in; The language(s) in which therapy will be provided and the rationale for this. Please make sure that goals address delay or disorder and specific problems.
10/27/2011	Notification Process for Admissions and Discharges from PRTF Providers	Title: Notification Process for Admissions and Discharges from PRTF Providers Run Dates: 10/26/2011 – 12/10/2011 PV Types: 01, Spc: 013, 015 We need to make you aware of a slight change in the notification process for admissions and discharges from your facilities. Effective Monday, October 31, 2011, admission and discharge information needs to be faxed to 405-530-7236. This slight change will allow immediate update of the member file to insure appropriate payments are made for these members and has no impact on your interaction with Optum for Prior Authorizations. A sample of the information needed on the form is included below for your information. You can find the form on the Optum website under “Provider & State Staff” tab in the inpatient forms section. Residential Admit/Discharge Reporting Form: Please note this is to be completed for every admit and discharge (this includes upgrades and downgrades) RTC level of care. Please fax to 405-530-7236. Please print clearly. Member Name Member SoonerCare ID Number Admit Date to RTC Level of Care Discharge Date from RTC Level of Care Facility Name Facility Provider ID number Facility Phone Number Form Completed by Remember to call Optum for all Prior Authorizations questions.
10/26/2011	5010 Webinar hosted by HP Enterprise Services	Title: 5010 Webinar hosted by HP Enterprise Services Run Dates: 10/25/2011 – 10/29/2011 Pv Types: All HP Enterprise Services will host a 5010 Webinar on Friday, October 28th from 1:30 – 2:30 central time. The following topics will be discussed: 5010 Overview; The SoonerCare Approach to 5010 Implementation; Tips for Passing Compliance; NCPDP D.0; NPI Crosswalk for 5010 ; What’s New: Secure Site Changes, New EDI Transaction; Q&A All SoonerCare EDI submitters, billing agents, clearinghouses, VANS, and software vendors that are familiar with loops and segments of the current 4010 requirements are welcome to attend this webinar event. Future 5010 teleconferences and webinar events will also be offered, dates and times to be determined. Please contact the EDI Helpdesk with any questions at (405) 522-0114, option 2, 2. Date: Friday October 28, 2011 Time: 1:30 -2:30 central time. Virtual room: https://www.rooms.hp.com/attend/default.aspx?key=EP2BVB4WXE Participant key: EP2BVB4WXE Conference dial in number: 866-409-2889 Conference Code: 4931653160
10/14/2011	Mirena IUD	Title: Mirena IUD Run Date: 10/24/2011 – 12/06/2011 PV Types: All SoonerCare reminds providers offering Mirena® birth control that OHCA reimburses for one IUD without prior authorization within a 5-year period. Additional IUDs require a prior authorization. Subsequent unit(s) must be medically necessary which does not include replacing an IUD product removed before the end of the 5-year IUD product life span because the member no longer wanted birth control.
10/19/2011	DMEPOS Provider Workshop	Title: DMEPOS Provider Workshop Run Dates: 10/19/11 thru 11/4/11 PV Types: 250 – DME/Medical Supply Dealers Please follow this link to register for the DMEPOS Provider Workshop scheduled to be held at the OHCA office in Oklahoma City on Monday, November 7, 2011 at 1:00 PM to 4:00 PM - (Expired Link) Space is limited so register soon. If you have specific areas of concern please indicate in the space provided on the registration. Topics to be covered are new DME Repair Claims Process, REUSE Program Update, Oxygen CMN Review, and other agenda items as time permits. Please sign in at the FAR NORTH entrance to Shepherd Mall located at 2401 NW 23rd St - Suite 1A, Oklahoma City, OK 73107. Contact Stan Ruffner, DMEPOS Director at stan.ruffner@okhca.org if you have any questions about this workshop.
10/18/2011	PA Contract Renewals (Expirations)	Title: PA Contract Renewals (Expirations) Run Date: 10/17/2011-12/01/2011 PV Types: 100 – Physician Assistants Dear Primary Care Provider: REMINDER: SoonerCare and Insure Oklahoma contracts for Physician Assistants will expire on January 31, 2012. OHCA requests that Physician Assistants who serve as PCPs for SoonerCare Choice or Insure Oklahoma renew their contracts before November 30, 2011. Because of system limitations, PCPs who have not completed contract renewals by November 30th will not appear in online provider directories and will not be able to receive new enrollments on their panels until the contract is renewed. Please note that groups, physicians, and nurse practitioners who have PCP contracts do NOT have to renew at this time. Only Physician Assistant contracts expire January 31st. If you have any questions regarding contract renewal, please call (800)522-0114 or (405)522-6205, option #5.
10/17/2011	5010 Conference Call Hosted by HP Enterprise Svs	Title: 5010 Conference Call Hosted by HP Enterprise Svs Run Date: 10/14/2011 – 10/22/2011 PV Types: All Target Audience: EDI Batch File Submitters HP Enterprise Services will host a 5010 conference call on Friday, October 21st from 1:30-2:30PM central time. The following topics will be discussed: 5010 testing update SoonerCare specific changes for 5010 (CN1) New Transactions 5010 Testing Request Form Announcement of NCPDP D.0 “go live” date Questions/Answers All SoonerCare EDI submitters, billing agents, clearinghouses, VANS, and software vendors are welcome to attend this teleconference. Please contact the EDI Helpdesk with any questions at (405) 522-0114, option 2, 2. Date: Friday October 21, 2011 Time: 1:30-2:30PM central time. Conference dial in number: 866-409-2889 Conference Code: 4931653160
10/13/2011	Customer Data Core (CDC) Training	Title: Customer Data Core (CDC) Training Run Date: 10/13/2011 – 11/01/2011 PV Type: 53 - LBHPs Customer Data Core (CDC) Training The purpose of this training is to help understand how to report data for the ODMHSAS/OHCA Customer Data Core (CDC; see links below). The training will hosted by Dr. Mark A. Reynolds, a 19-year employee of ODMHSAS. The trainings will be split into different groups. Two trainings will focus on the CDC and how it pertains to individually-contracted LBHPs and the other two will be focused on the CDC and how that affects outpatient agencies. This is an OPTIONAL training and is focused on the data elements. This training will NOT be covering data entry in ProviderConnect. It is strongly recommended that each attendee log in 10-15 minutes prior to the start of the webinar. Thank you and hope to see you there. CDC Training for Individually-contracted LBHPs (not working at outpatient agencies) Tue, Oct 18, 2011 9:00 AM - 10:00 AM CDT Mon, Oct 24, 2011 2:00 PM - 3:00 PM CDT CDC Manual: www.odmhsas.org/CDCManualFY12.pdf CDC Form: www.odmhsas.org/CDCFormFY1220110825.pdf
10/11/2011	Updated CPT-HCPCS Codes	Title: Updated CPT-HCPCS Codes Run Date: 10/10/2011 – 11/25/2011 PV Types: 01 – Hospitals 02 – Ambulatory Surg Ctr 08 – Clinics 31 – Physicians 52 – State Employed Physicians In excess of 185 CPT/HCPCS codes failed to update in the July 1, 2011 Physician Fee Schedule (PFS) update. These codes were updated by 9/1/2011. All claims with a date of service after 06/30/2011 that were processed between 07/01/2011 and 08/31/2011 which contain affected codes will be reprocessed. The reprocessed claims will appear on provider remits 10/26/2011 and the ICN will begin with “5211286”. Reprocessing will result in either a slightly higher or a slightly lower payment. The change in payment should not be significant.
10/7/2011	General Info to BH Providers re: OPTUM, etc	Title: General Info to BH Providers re: OPTUM, etc Run Date: 10/07/2011 – 11/22/2011 PV Types: 11 – Mental Health Provider 011 - Psychiatric 110 – Outpatient Mental Health Clinic 111 – Community Mental Health Center (CMHC) 112 - Psychologist 118 – Mental Health/DMHSAS 535 - Licensed Mental Health Professional (LBP) 45 - Residential Behavior Management 53 - Licensed BH Practitioner 533 – Behavioral Health Rehab Spc 535 Licensed Mental Health Professional - LBPs As part of the OHCA commitment to our Behavioral Health provider community we want to assist you in a timely manner when you have questions. Please note the following contact information. OPTUM Health is our new Prior Authorizations (PA) vendor. Please continue to contact them for PA submissions and subsequent follow-up at: 2401 NW 23rd Street Suite 1B, OKC, OK 73107; phone (800)854-0833; FAX (855)543-5921; or their website at www.optumhealthoklahoma.com. For all other inquiries please call the OHCA Call Center at (800)522-0114 or locally (405)522-6205. ‘Option 1’ will assist you with claims, policy, and general questions about the agency. ‘Option 5’ will connect you with an experienced provider enrollment staff member to assist with your contract questions. With recent changes in Behavioral Health staff we wanted to remind you that OHCA has many OHCA staff able to assist you in a timely manner. Thank you for your continued support of our SoonerCare members.
10/4/2011	Speech Therapy re: More than one CPT code	Title: Speech Therapy re: More than one CPT code Run Date: 10/04/2011 – 11/19/2011 PV Types: 173 Speech/Hearing Therapist 182 Speech/Hearing Clinic When requesting approval for more than one CPT code, you must identify which goal (s) will be addressed for each CPT code. This helps the consultant evaluate appropriateness of the units requested for each service. When responding to a request for additional information, please initial and date any revisions. Also, initial any corrections made to the forms. This will help the reviewer identify the new information.
10/4/2011	IFMC Name Change [To Telligen]	TITLE: IFMC Name Change [To Telligen] Run Date: 10/04/2011 – 11/19/2011 PV Types: All OHCA has worked with IFMC since February 2008 with the launch of the SoonerCare Health Management Program. OHCA’s relationship with IFMC expanded when they took over responsibility for External Quality Review functions on July 1, 2011. They continue to support both programs and have been an important partner of the Health Care Authority. IFMC recently announced a change in their corporate identity which included a new corporate name. Their new name is Telligen. This change is effective immediately. Although the name has changed, all other aspects of program operations will remain the same. Telligen will continue to operate from the same office in Oklahoma City with the same mailing address and phone numbers. The only other change is the email address for Telligen staff. The new domain name is Telligen.org (replacing IFMC.org).
9/20/2011	2011 CPT codes for Pelvic & Abdominal Tomographies	Title: 2011 CPT codes for Pelvic & Abdominal Tomographies Run Date: 09/19/2011 – 12/19/2011 PV Types: 341 – Radiologist 2011 CPT has combined the codes for pelvic and abdominal tomographies into three new codes, 74176, 74177, and 74178. The old codes for the abdomen and the pelvis still exist, but when the two services are performed together the new codes should be billed. Our system is automatically rebundling your 2010 claims with the old codes and paying for the combined service. We have initiated a protocol to process these 2010 service dates and pay them as they would have been reimbursed prior to 2011. Please resubmit all 2010 claims that have been denied or paid incorrectly for reprocessing. Claims for service dates after 1/1/2011 should be billed using the new codes when these services are combined. Beginning Monday, 09/15/2011, you will have 90 business days to resubmit these claims. After that we will need to change the system back to support 2011 CPT code claims criteria.
9/12/2011	Outpatient Behavioral Health Agency Providers: Individual Rendering Provider Enrollment Information	TITLE: Outpatient Behavioral Health Agency Providers: Individual Rendering Provider Enrollment Information Run Date: 09/12/2011 – 10/23/2011 PV Types: 110 – Outpatient Mental Health Clinic 111 – Community Mental Health Center (CMHC) 118 – Mental Health – DMHSAS 114 - PACT This communication only applies to OPBH agency providers: Very important: Make sure you fax all of the required documents when you complete the electronic provider enrollment form. The provider enrollment department processes the application based on receipt of the required fax. The individual staff have to sign the provider agreement. There is no exception to the staff signature requirement. Under Supervision for Licensure: License Number: TEMP Original Issue Date: List the start date of the board approved supervision agreement. Expiration Date: The estimated end date for the supervision. Required Document to Fax: The licensure department’s approved supervision agreement.
9/12/2011	Fluoride Varnish	Title: Fluoride Varnish Run Date: 09/12/2011 – 10/23/2011 PV Types: All Attention Medical Home Providers: This is a reminder that Primary Care Providers may be reimbursed for the application of fluoride varnish beginning 7-1-2011. Please see OHCA 2011-32 for specifics! OHCA wishes to clarify some confusion regarding the training required to provide and be reimbursed for this procedure. Online required training is available at www.aap.org/oralhealth (Smiles for Life National Oral Health Curriculum). Two sessions are required: 1) Child Oral Health Assessment &, 2) Fluoride Varnish. If your office has submitted certificates for other curriculums this could prevent us from certifying you and could affect payment. Thank you for your cooperation.
9/12/2011	Provider Letter 2011-40 Re: Hydroxyprogesterone Injections	Title: Provider Letter 2011-40 Re: Hydroxyprogesterone Injections Run Date: 09/12/2011-10/27/2011 PV Types: All The effective date for Provider Letter 2011-40, re: Hydroxyprogesterone injections prior authorization requirement, is 09/15/2011. If you have denied claims for dates of service prior to 09/15/2011, please refile your claims.
9/8/2011	Reminder: 2011 Fall Training Registration	Title: Reminder: 2011 Fall Training Registration PV: All Run Date: 09/08/2011 – 10/31/2011 Registration for the Durant Fall Workshop [scheduled for September 14th, 2011] closed effective 09/07/2011. Walk-in registration will be allowed at this location beginning at 8:00 a.m. on September 14th. Workshops will begin at 8:30 a.m. Lawton, OKC and Tulsa registration remains open at this time. Register today! We look forward to seeing you this Fall!
8/31/2011	2011 Fall Provider Workshop Training	Title: 2011 Fall Provider Workshop Training Run Date: 08/31/2011 – 10/25/2011 PV Types: All PLEASE JOIN US FOR THE 2011 FALL PROVIDER WORKSHOP! By attending, you and your office will receive invaluable information on SoonerCare policies, programs, utilization tips and recent changes. Specific classes include HIPAA Version 5010 for SoonerCare, a general overview of Prior Authorization Submissions, a Provider’s Guide to Care Management Services and Medical Home Audit Process, just to name a few! Register today! Information and registration is available on our training page. Durant, OK will be the first stop on September 14th followed by: Lawton, September 29th; Tulsa, October 11th – 12th; and, conclude in Oklahoma City, October 26th – 27th.
8/31/2011	WEBINAR: Rendering Provider ID/Master PA	Title: WEBINAR: Rendering Provider ID/Master PA Run Date: 08/29/2011 – 09/27/2011 PV Types: 110 – Outpatient Mental Health Clinic 111 – Community Mental Health Center (CMHC) 118 – Mental Health – DMHSAS 114 - PACT Outpatient Behavioral Health Contracted Agencies: Webinar trainings will be hosted by the OHCA and will review two major changes for OPBH contracted agencies: rendering requirement on the claim, and, the assignment of a Master PA ID for the agency. These changes will be implemented on October 1, 2011 and apply only to OPBH agencies. This training does not pertain to private practitioners, LBHPs or psychologists. The first change is the requirement to enroll the OPBH agency individual rendering staff with OHCA. Effective 10/01/2011, the individual rendering provider number will be required on all OPBH claims. The second change is the assignment of the Agency Master PA ID for OPBH agencies. It is important for all individuals who provide services within a behavioral health outpatient agency and any person responsible for billing at your OPBH agency to attend this training. There are a limited number of spaces available for the webinars. Register for one of the webinars now by using the internet address listed below: Wednesday, 09/07/2011, 9:00 – 10:00 a.m.: https://www1.gotomeeting.com/register/778150713 Tuesday, 09/13/2011, 3:30 – 4:00 p.m.: https://www1.gotomeeting.com/register/783242320 Monday, 09/26/2011, 10:00 – 11:00 a.m.: https://www1.gotomeeting.com/register/366483072
8/22/2011	School-Based Training	Title: School-Based Training Run Dates: 08/22/2011 – 09/29/2011 PV Types: 12, 120 School Corp School-Based Training is scheduled for the following dates: September 19, 2011 – Poteau (1:00pm to 03:00pm) September 22, 2011 – Stillwater (10:00am to 12:00pm) September 28, 2011 – McAlester (10:00am to 12:00pm) September 29th,2011– Oklahoma City (10:00am to 12:00pm) Please register here for the training.