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Global Messages

2024 Global Messages

DATE POSTED TITLE MESSAGE
4/5/24 Long-Acting Reversible Contraceptives (LARC) Training

Provider types: 08, 09, 10,13, 16, 31, 52

The Focus Forward Oklahoma program works to address issues related to access and utilization of long-acting reversible contraceptives (LARC). No-cost LARC training is available to Oklahoma providers, clinical support staff and administrative staff. There is currently one training scheduled in April 2024.

For more information about Focus Forward and available training, visit our Provider Training web page.

3/29/24 SoonerSelect Webinar Featuring Our Partner Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program

Provider Types:  All

Topics will include but are not limited to an overview of Availity, how to file a prior authorization, and how to file a claim.

Please note that there two are separate opportunities to hear from each CE for Behavioral Health Providers, PT/OT/ST providers and all other provider types.

Behavioral Health Providers

Click here to register for the Behavioral Health session with Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program at 9 a.m. on Thursday, April 11, 2024.

Click here to register for the Behavioral Health session with Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program at 2:30 p.m. on Tuesday, April 16, 2024.

PT/OT/ST

Click here to register for the PT/OT/ST webinar session with Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program at 11:30 a.m. on Thursday, April 11, 2024.

Click here to register for the PT/OT/ST webinar session with Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program at 9 a.m. on Tuesday, April 16, 2024.

All other providers

Click here to register for all other providers' webinar session with Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program at 2:30 p.m. on Thursday, April 11, 2024.

Click here to register for all other providers' webinar session with Oklahoma Complete Health and Oklahoma Complete Health Children’s Specialty Program at 11:30 a.m. on Tuesday, April 16, 2024.

3/29/24 SoonerSelect Webinar Featuring Our Partner Humana Healthy Horizons in Oklahoma

Provider Types:  All

Topics will include but are not limited to an overview of Availity, how to file a prior authorization, and how to file a claim.

Please note that there two are separate opportunities to hear from each CE for Behavioral Health Providers, PT/OT/ST providers and all other provider types.

Behavioral Health Providers

Click here to register for the Behavioral Health session with Humana Healthy Horizons in Oklahoma at 9 a.m. on Wednesday, April 10, 2024.

Click here to register for the Behavioral Health session with Humana Healthy Horizons in Oklahoma at 2:30 p.m. on Thursday, April 18, 2024.

PT/OT/ST

Click here to register for the PT/OT/ST webinar session with Humana Healthy Horizons in Oklahoma at 11:30 a.m. on Wednesday, April 10, 2024.

Click here to register for the PT/OT/ST webinar session with Humana Healthy Horizons in Oklahoma at 9 a.m. on Thursday, April 18, 2024.

All other providers

Click here to register for all other providers' webinar session with Humana Healthy Horizons in Oklahoma at 2:30 p.m. on Wednesday, April 10, 2024.

Click here to register for all other providers' webinar session with Humana Healthy Horizons in Oklahoma at 11:30 a.m. on Thursday, April 18, 2024.

3/29/24 SoonerSelect Webinars Featuring Our Partner Aetna Better Health of Oklahoma

Provider Types:  All

Topics will include but are not limited to an overview of Availity, how to file a prior authorization, and how to file a claim.

Please note that there two are separate opportunities to hear from each CE for Behavioral Health Providers, PT/OT/ST providers and all other provider types.

Behavioral Health Providers

Click here to register for the Behavioral Health session with Aetna Better Health of Oklahoma at 9 a.m. on Tuesday, April 9, 2024.

Click here to register for the Behavioral Health session with Aetna Better Health of Oklahoma at 2:30 p.m. on Wednesday, April 17, 2024.

PT/OT/ST

Click here to register for the PT/OT/ST webinar session with Aetna Better Health of Oklahoma at 11:30 a.m. on Tuesday, April 9, 2024.

Click here to register for the PT/OT/ST webinar session with Aetna Better Health of Oklahoma at 9 a.m. on Wednesday, April 17, 2024.

All other providers

Click here to register for all other providers' webinar session with Aetna Better Health of Oklahoma at 2:30 p.m. on Tuesday, April 9, 2024.

Click here to register for all other providers' webinar session with Aetna Better Health of Oklahoma at 11:30 a.m. on Wednesday, April 17, 2024.

3/29/24 SoonerSelect Eligibility Verification

Provider Types:  All

Exciting news! If a member is enrolled in the SoonerSelect dental program (SoonerDental), you are now able to verify in which plan the member is enrolled. Click on the + (plus) sign in the Managed Care section of the eligibility screen and it will expand to show you the member’s plan name.

Example Image #1

Example Image #2

Please note:
If a member is in the SoonerSelect health program, this option will be available beginning April 1, 2024.

3/29/24 PCMH Care Coordination Payments

Provider Types:  08/080, 081, 082, 088, 184, 185; 31/316, 318, 322, 344, 345, 568; 10/100; 09/093

OHCA made the last PCMH care coordination payment for members transitioning to SoonerSelect on Feb. 28, 2024. The February 2024 payment is a prospective payment for March 2024.

Beginning April 2024, the contracted entities (CE) will make the PCMH care coordination payments for SoonerSelect members. Each CE will have a PCMH payment calendar; please see below for additional information regarding PCMH payments per plan. 

  • Humana will make the April PCMH payment by April 17. Going forward, Humana PCMH payments will be paid monthly, no later than the 15th of the month.
  • Aetna will make the April PCMH payment on April 17. Going forward, Aetna PCMH payments will be processed on the first Sunday of the month with the payment going out approximately three days after.
  • Oklahoma Complete Health will make the April PCMH payment on April 17. Going forward, Oklahoma Complete Health payments will be made the first Wednesday of the month (unless the 1st of the month is a Wednesday, in which case, payment will be made the second Wednesday of the month).

OHCA will continue to make PCMH care coordination payments for members who are not enrolled in SoonerSelect but who are still eligible to receive services through SoonerCare PCMH.

Please make sure you have submitted your EFT info to the plans.

3/29/24 SoonerSelect Health Plans and SoonerSelect Children’s Specialty Program begin April 1, 2024

Provider types:  All Providers

OHCA encourages all health care providers to contract with each SoonerSelect health plan — Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma, Oklahoma Complete Health, and Oklahoma Complete Health for the Children’s Specialty Program — to continue serving all SoonerCare members who have transitioned to SoonerSelect. Contact the health plans for more information on provider contracting.

Visit the SoonerSelect page for contact information, provider directories, benefit guides and member handbooks.

More materials include day one guides, FAQs and other resources that will help you continue to serve members.

3/15/24 Important Information Regarding Prior Authorizations and Billing for SoonerCare Behavioral Health Providers Contracted and NOT Contracted with ODMHSAS

Provider types: 017, 110, 111, 112,114, 115, 116, 118, 121, 134, 135, 136, 137,138 

Message: Effective April 1, 2024, due to the transition to SoonerSelect, there will be some important changes to prior authorizations and requirements for completion of the Customer Data Core (CDC). SoonerSelect DMH Contracted and Non-Contracted Providers.pdf (oklahoma.gov)

3/5/24 SoonerSelect Dental Webinars Featuring Our Partners DentaQuest and LIBERTY Dental

Provider Types:  27/270-279, 08/081 & 086

Don’t miss this amazing opportunity to hear from our partners DentaQuest and LIBERTY Dental. There is still space available; register using the links below. 

Topics will include but are not limited to continuity of care period, prior authorizations, contracting/credentialing and dental home.

Click here to register for the LIBERTY Dental session at 2 p.m., Tuesday, March 5, 2024.

Click here to register for the LIBERTY Dental session at 10 a.m., Thursday, March 7, 2024.

Click here to register for the DentaQuest session at 2 p.m., Thursday, March 7, 2024.

Click here to register for the DentaQuest session at 10 a.m., Wednesday, March 13, 2024.  

Click here to register for the LIBERTY Dental session at 2 p.m., Wednesday, March 13, 2024.

3/5/24 Psychiatric Collaborative Care and Behavioral Health Integration Services

Provider Types: 08, 09, 10, 31, and 52

Effective Nov. 1, 2023, OHCA has added coverage for psychiatric collaborative care and behavioral health integration services. Coverage and billing information for these services can be found here.

3/4/24 SoonerSelect Provider Information Requests

Provider Types: All

OHCA has been working with our SoonerSelect partners to ensure they have an adequate network to serve our SoonerCare members. The health plans may need additional information from our provider community to complete provider files and update provider directories. OHCA is aware of these requests and asks that you work with the health plans by sharing the additional requested information to ensure they have complete and accurate provider information for our members.   

3/1/24 SoonerSelect Dental Webinar Cancelation

Provider Types:  27/270-279, 08/081 & 086

Description:  Due to unforeseen circumstances the SoonerSelect dental webinar with DentaQuest that was scheduled for 10 a.m., Tuesday, March 5, has been canceled.  Please remove this webinar from your calendar and sign up for one of the remaining sessions.

Click here to register for the DentaQuest session at 2 p.m., Thursday, March 7, 2024 

Click here to register for the DentaQuest session at 10 a.m., Wednesday, March 13, 2024

3/1/24

Long-Term Care PFP Payment Update

TITLE: Nursing Facility Pay for Performance (PFP) Payment Update

Run Date: 2/26/2024 – 3/8/2024

PV Type:  03/ 30,35

SFY 2024 3rd quarter PFP payment will be made on Feb. 28, 2024.

We thank you for your continued service to SoonerCare members.

3/1/24 Long-Term Care Enhanced Payment Update

TITLE: ICF/IID Vocational & Day Services Enhanced Payment -Update

Run Date: 02/26/2024 – 03/08/2024

PV Type: 03/ 31,34

SFY 2024 3rd quarter enhanced payment for vocational and day services will be made on Feb. 28, 2024.

We thank you for your continued service to SoonerCare members.

3/1/24 Licensed Behavioral Health Renewals 2024

Provider Types/Specialties: 093, 115, 121, 535, 585, 586, 587

Providers:

This is a reminder that licensed behavioral health provider contracts (type 53 including LADC, LMFT, LPC, LBHP and LCSW) are set to expire Feb. 28, 2024. Contracts that have not had a renewal completed by Feb. 29, 2024, will be unable to submit claims until their renewal has been submitted and approved. OHCA will be unable to prioritize renewals for any provider submitted after Feb. 28, 2024, and all renewals will be processed based on the date received. Failure to complete a renewal will result in the provider being required to submit a new application to become credentialed with SoonerCare.

2/26/24 SoonerSelect Dental Webinars Featuring Our Partners DentaQuest and LIBERTY Dental  

Provider Types:  27/270-279, 08/081 & 086

Description:  Please join us for one or more sessions presented separately by our dental partners, DentaQuest and LIBERTY Dental. Topics will include but are not limited to continuity of care period, prior authorizations, contracting/credentialing and dental home.

Click here to register for the LIBERTY Dental session at 2 p.m., Tuesday, March 5, 2024

Click here to register for the LIBERTY Dental session at 10 a.m., Thursday, March 7, 2024

Click here to register for the DentaQuest session at 2 p.m., Thursday, March 7, 2024

Click here to register for the DentaQuest session at 10 a.m., Wednesday, March 13, 2024

Click here to register for the LIBERTY Dental session at 2 p.m., Wednesday, March 13, 2024 

2/20/24 Request for Coverage Consideration

Providers: All

Providers and vendors may request consideration for SoonerCare coverage of a new service, procedure, technology, device or other benefit. For your request to be considered, please complete and submit a Request for New SoonerCare Coverage Consideration Form.

Remember to attach any requested supporting documents and any other evidence-based documents you wish to be considered in this review of coverage to the completed form. Completed forms should be submitted by email to massunit@okhca.org.

Investigational, non-FDA approved, experimental or solely cosmetic services will not be considered for coverage. All services must be medically necessary in accordance with OAC 317:30-3-1(f).

2/20/24 Medical and DME Retro PA Requests

Provider Type – All Medical and Durable Medical Equipment Providers

01/010, 012, 014,- 018, 201, 206,  02/020 - 022, 06/060, 08/080 -082, 084, 085, 088, 106, 181, 183, - 186, 188, 192, 194 -199, 202, 203, 208, 801, 802, 09/90-96, 210, 211, 564, 999 10/100-102, 14/140, 18/180, 19/190, 207 22/220, 25/220, 250-253, 277, 28/280-281, 29/290-292, 31/272, 310-338, 340-352, 354-359, 520-529, 540-552, 554-566, 568, 569, 999  

In response to feedback from medical and durable medical equipment (DME) providers about the practical challenges that cessation of retroactive prior authorization (PA) requests causes, OHCA is changing its requirements. 

OHCA will allow retro PA requests to be submitted up to five business days after the first service date.  Please limit your submissions to retro requests of no more than five business days after the first date of service. Requests beyond the five days will be canceled.  

Medical imaging retro PA requests will remain at three business days.

2/20/24 Dental Retro PA Requests

Provider Type – All Dental Providers

021, 086, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 999

In response to feedback from dental providers about the practical challenges that cessation of retroactive prior authorization (PA) requests causes, OHCA is changing its requirements. 

OHCA will allow retro PA requests to be submitted up to five business days after the first service date. Please limit your submissions to retro requests of no more than five business days after the first date of service. Requests beyond the five days will be canceled.  

2/8/24 C-Section Rate Letters

PV Types: 01, 08, 31, 52

The year-end C-section rate letters for state fiscal year 2023 are now available through the OHCA Provider Portal. As a reminder, these C-section letters are now only available electronically.

If you need help to retrieve your letters, please call 800-522-0114.

You may also view the SoonerCare C-section rates and reports available on the Cesarean Reports webpage.

Thank you.

2/1/24 SoonerSelect Dental – Getting Started and Preparedness for Day One Webinar

Provider Types: 27/270-279, 08/080-081 & 086

This class will provide you with the tools you need to be successful during the transition and implementation of the SoonerSelect Dental Program. Join us at 10-11 a.m., Thursday, Feb. 8, 2024. Click here to register.

1/30/24 SoonerSelect and School-Based Services pursuant to an IEP or IFSP

Provider Type: 12/120

Targeted Audience: OHCA-contracted school districts and OHCA providers that provide Medicaid services pursuant to an IEP or IFSP.

OHCA is delaying including school-based and SoonerStart program services in SoonerSelect for the first 15 months from the date of SoonerSelect implementation (April 1, 2024). Through the 15-month extension, school-based and SoonerStart services will be processed and reimbursed through OHCA, maintaining current reimbursement practices. Health and Children’s Specialty Program CEs will reimburse OHCA-enrolled qualified school providers and SoonerStart providers beginning July 1, 2025. If you have any questions regarding this global, please email Lana.Brown@okhca.org.

1/25/24 Dental CRNA Coding and Services

Provider Types: 27/270-279, 08/080-081 & 086 09/94

All dental providers using CRNA services and/or billing for in-office sedation, other than nitrous oxide, should review the terms and conditions for billing and coding to ensure that you are in compliance with federal regulations, state policies and other guidelines. We strongly encourage a review of your contract language to ensure your coding and billing practices are compliant with documentations standards, policy and other applicable regulations. CRNA services must be billed with the actual servicing provider listed as the rendering provider on the claim, and all rendering providers must have a contract with OHCA (O.A.C. 317:30-3-1(b)). OHCA will soon be providing additional education and clarity on this subject. Until then, please review your coding and practices and align them with required practices and policy.

1/25/24 SoonerSelect Dental- Getting Started and Preparedness for Day One Webinar

Provider Types: 27/270-279, 08/080-081 & 086

This class will provide you with the tools you need to be successful during the transition and implementation of the SoonerSelect Dental Program.

Jan 30, 2024, 10:00-11:30 AM. Click here to register.

1/25/24 SoonerPlan FPL Threshold

Provider Types/Specialties: All

The Oklahoma Health Care Authority has raised the FPL threshold for the SoonerPlan program. View the new income guidelines on the OHCA website. This change will expand access to reproductive health services for individuals ages 19 and older who are uninsured or underinsured and do not qualify for these services through other SoonerCare programs.

The goals are to improve outcomes across the State in:

  • Healthy birth spacing.
  • Infant and maternal mortality and morbidity rates.
  • Adolescent health and teen pregnancy prevention.
  • Health disparities.

The effective date for the new income guidelines is Jan. 1, 2024.

1/25/24 Quarterly Orthodontic Payments

Provider Types: 27/270-279, 08/080-081 & 086

Effective Feb. 1, 2024, the orthodontic payment structure will change from three yearly bulk payments over a 36-month period to one yearly bulk payment and four quarterly payments over a 24-month period. Dental providers can review information regarding this change by visiting our Provider Training page and viewing the Quarterly Orthodontic Payments document found under Resources.

1/24/24 SoonerSelect Dental Eligibility Verification

Provider Type: Dentists 27, 270-279, 08, 080, 081, 086

This is to inform you that the SoonerCare Provider Portal will be able to show if a member is enrolled in the SoonerSelect Dental Program; however, it will not show the dental plan assignment until or after 2/15/2024. Follow the steps below to check member SoonerSelect Dental Program eligibility and identify plan assignment until the Provider Portal is updated.

1. Verify eligibility on OHCA secure provider portal; look for SoonerDental, if not listed, the member remains on traditional SoonerCare so you may continue as usual; if SoonerDental is returned in your results, please continue to Step 2.

2. Verify eligibility with the member’s plan, LIBERTY LIBERTY Dental Plan of Oklahoma  or DentaQuest www.DentaQuest.com via their provider portal. If unable to determine which plan the member is assigned to, ask the member for their ID card, and proceed with contacting their plan.

3. If you are unable to determine eligibility, please call the Provider Helpline at 1-800-522-0114, Option 1 for assistance.

We have an upcoming training for dental provider’s and their staff on January 30, 2024, at 10:00 am., titled “SoonerSelect Dental – Getting Started and Preparedness for Day One”. You may register for training here. We look forward to sharing important information about our SoonerSelect Dental program.

1/11/24 Medical and DME Retro Prior Authorizations

Provider Type: All Medical Providers and All Durable Medical Equipment Providers

01/010, 012, 014,- 018, 201, 206,  02/020 - 022, 06/060, 08/080 -082, 084, 085, 088, 106, 181, 183, - 186, 188, 192, 194 -199, 202, 203, 208, 801, 802, 09/90-96, 210, 211, 564, 999 10/100-102, 14/140, 18/180, 19/190, 207 22/220, 25/220, 250-253, 277, 28/280-281, 29/290-292, 31/272, 310-338, 340-352, 354-359, 520-529, 540-552, 554-566, 568, 569, 999  

Effective Feb. 1, 2024, OHCA will no longer issue retroactive authorizations for medical services or durable medical equipment (DME).

This change applies specifically to prior authorizations submitted via the secure provider portal utilizing the medical radio button.

Authorization processes currently in place for behavioral health services are not included in this change. 

Please submit any outstanding authorization requests (that fall within the currently allowed retroactive date timeframe) for retroactive authorizations no later than close of business on Jan. 31, 2024.  A complete request must be submitted by close of business Jan. 31, 2024 to avoid cancellation.

1/10/24 Dental Retro Prior Authorizations

Provider Type: All Dental Providers

021, 086, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 999

Effective Jan. 27, 2024, dental services will no longer be authorized retroactively. Services that require a prior authorization must be requested and approved prior to rendering.

All requests for outstanding retroactive dental services must have a complete request submitted by close of business Jan. 26, 2024, to avoid cancellation.

1/9/24 Oklahoma Health Information Exchange (HIE) Updates webinar

The Office of the State Coordinator for Health Information Exchange (HIE) and State-Designated Entity, MyHealth Access Network, invite participants to a virtual speaking engagement. The webinar will provide an overview of the purpose, framework and coverage of the HIE, the approved emergency rules surrounding broad based exemptions, connection fee assistance, and provider incentive directed payments for those who connect and utilize the HIE. These directed payment incentives can result in a significant reimbursement increase for the provider types listed below.

Providers eligible for the directed payments include advanced practice nurses, mid-level practitioners, mental health providers and licensed behavioral health practitioners1, podiatrists, physicians2, and anesthesiologist assistants.

Click here to register for the Oklahoma Health Information Exchange (HIE) Updates webinar from 11 a.m.-12:30 p.m., Wednesday, Jan. 24, 2024.

1Behavioral health services by mental health professionals and licensed behavioral health practitioners at community mental health centers are excluded as they participate in a separate directed payment program.

2Services rendered by state employed or contracted physicians are excluded as they participate in a separate directed payment program.

Provider Type/Specialty: All

1/5/24 Quality Improvement Fluoride Varnish (QIFV) Project Webinar

Provider Types/Specialties: Primary care and pediatric providers doing well-child checks

The Oklahoma Health Care Authority is presenting a webinar for SoonerCare providers on Tuesday, Jan. 16. The Quality Improvement Fluoride Varnish (QIFV) project is aimed at increasing the use of fluoride varnish for children in medical clinics, decreasing the incidence of dental caries in SoonerCare children, and improving the overall health of SoonerCare kids.

Visit the OHCA Provider Training page to register to attend the QIFV webinar from 2-3:30 p.m., Tuesday, Jan. 16. After registering, you will receive a confirmation email containing information about joining the webinar and reminder emails before the webinar begins. Registrants unable to attend the webinar session should notify SoonerCareEducation@okhca.org to cancel their registration.

 

The year-end C-section rate letters for state fiscal year 2023 are now available through the OHCA Provider Portal. As a reminder, these C-section letters are now only available electronically.

 

If you need help to retrieve your letters, please call 800-522-0114.

 

You may also view the SoonerCare C-section rates and reports available on the Cesarean Reports webpage.

 

Thank you.

Last Modified on Apr 05, 2024