Global Messages
2023 Global Messages
Date Posted | Title | Message |
3/15/23 | Referral bypass for outpatient place of service | Provider Types: 08, 09, 10, 31, 52 Effective immediately, professional claims with place of service 22 (outpatient) will no longer require referrals from the primary care physician. |
3/9/23 | Behavioral Health/ABA Services Webinar | Provider Types/Specialties: 17/ 176-178 During this webinar from 2-3:30 p.m., Thursday, March 30, providers will familiarize themselves with an overview of ABA medical necessity criteria and prior authorization. Visit the OHCA Provider Training page to register. You will receive a confirmation email with 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. |
3/7/23 | EPSDT Screening and Sick Visit Same Day | Provider Types: 08, 09, 10, 31, 52 Effective for dates of service beginning March 1, 2023, OHCA will begin reimbursing for an evaluation and management service in addition to an Early Periodic Screening, Diagnosis and Treatment (EPSDT) screening for children ages 0-20 when appropriate. The EPSDT screening is still considered a comprehensive examination. However, if a member is receiving an EPSDT screening and an additional focused complaint arises that requires additional evaluation and management to address the complaint, the provider may deliver all medically necessary care and submit a claim for both the EPSDT screening and the appropriate level of focused service if the following requirements are met:
When providing evaluation and management of a focused complaint during an EPSDT screening, the provider may claim only the additional time that is required above and beyond the completion of the comprehensive EPSDT screening. An insignificant or trivial problem that is encountered in the process of performing the preventive evaluation and management service and does not require additional work is included in the EPSDT visit and should not be billed/reported. Additional information regarding EPSDT visits can be found in OHCA Policy PART 4. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program/Child Health Services (oklahoma.gov). |
2/24/23 | Nursing Facility Pay-for-Performance (PFP) Payment Update | PV Type: 03/30, 35 SFY 2023 Third Quarter PFP payment will be made on Feb. 22, 2023. We thank you for your continued service to SoonerCare members. |
2/24/23 | C-Section Rate Letters | PV Types: 01, 08, 31, 52 The year-end C-section rate letters for state fiscal year 2022 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 C-section rate release schedule on the OHCA webpage at www.okhca.org/c-section. Thank you. |
2/10/23 | Third Party Liability/HMS Webinar | Provider Types/Specialties: All During this webinar from 2-3:30 p.m., Thursday, Feb. 16, providers will familiarize themselves with an overview of OHCA’s Third Party Liability and HMS process. Visit the OHCA Provider Training page to register. You will receive a confirmation email with 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. |
2/3/23 | Eye Care Record Retention | Target Audience: Eye Care Providers As a reminder, please have the member or representative sign for the eyewear and maintain medical records for a minimum of six years per OAC 317:30-3-15. Record retention. |
1/20/23 | Dental Fee Adjustments | Providers: 27/270-279, 08/080-081 & 086 The Oklahoma Healthcare Authority has recently undergone a fee adjustment that was set with the effective date of Oct. 1, 2022. Claims filed from that date forward undergo claims recycle that is in progress. Per policy, providers are required to indicate their usual and customary charge when submitting claims. Providers who bill the SoonerCare allowable fee are advised to void and refile their claims from date of service Oct. 1, 2022 forward with their fees per policy. Please see Usual and Customary fee policy found at 317:30-3-5.1. Usual and Customary fees (oklahoma.gov) |
1/17/23 | Modifier 90 – Reference Laboratory | Providers: Hospital (01), Clinic (08), Advance Practice Nurse (09), Mid-Level Practitioner (10), Laboratory (28), Physician (31), State Employed Physicians (52) In May 2022, OHCA made updates in the MMIS claim system to change modifier 90 (reference [outside] laboratory) from an informational modifier to a denial modifier. OHCA has now set modifier 90 back to be an informational-only modifier, effective May 12, 2022. Providers who received denials for claims lines where modifier 90 was applied may now refile those claims, if appropriate. Timely filing rules will apply. |
1/10/23 | Molecular Diagnostic Testing for Infectious Diseases (update) | Providers: All OHCA has updated coverage for laboratory testing of infectious diseases using molecular testing (CPT 87471-87801) effective Jan. 1, 2023. Providers will find the updated coverage guidelines on the Medical Authorization Unit’s webpage. Changes include reopening coverage for CPT code 87634 (RSV) and 87637 (COVID-19, Flu A&B, and RSV) when performed by hospital labs, independent labs or clinic labs for symptomatic individuals who are immunocompromised, have chronic respiratory illness or influenza complicated by pneumonia, or who are pregnant. |
1/3/23 | Upcoming Webinar: Improving Care Coordination, Delivery, and Quality Utilizing Oklahoma’s Health Information Exchange | Target Audience: Licensed Oklahoma Providers and Organizations OHCA will present a webinar titled Improving Care Coordination, Delivery, and Quality Utilizing Oklahoma’s Health Information Exchange at 12 p.m., Thursday, January 26. This webinar will provide the details of recent legislation regarding participation in Oklahoma’s state-designated Health Information Exchange (HIE), review the capabilities and benefits of utilizing the HIE to provide care and services, and discuss the process for joining and getting connected to the HIE. Presenters: Visit the OHCA Provider Training page to register. 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. |
Archived
Global Messages
2022 Global Messages
2021 Global Messages
2020 Global Messages
2019 Global Messages
2018 Global Messages
2017 Global Messages
2016 Global Messages
2015 Global Messages
2014 Global Messages
2013 Global Messages
2012 Global Messages
2011 Global Messages
2010 Global Messages
2009 Global Messages
2008 Global Messages
2007 Global Messages
2006 Global Messages