Library: Policy

317:25-7-10. Enrollment with a Primary Care Provider (PCP)

Revised 9-14-20

(a) All SoonerCare Choice members described in Oklahoma Administrative Code (OAC) 317:25-7-12 may enroll with a PCP. SoonerCare Choice applicants have the opportunity to select a PCP during the application process. Enrollment with a PCP may begin any day of the month.

(1) The OHCA offers all members the opportunity to choose a PCP from a directory which lists available PCPs.

(2) When a notice of PCP enrollment is sent to a member, the member is advised of the right to change a PCP at any time.

(b) Members may receive services from a PCP or from a provider to which the member has been referred by a PCP. Notwithstanding this provision, subject to limitations which may be placed on services by the OHCA, members may self-refer for preventive or primary care services rendered by another SoonerCare contracted provider, outpatient behavioral health services, vision services for children, dental services, child abuse/sexual abuse examinations, prenatal and obstetrical services, family planning services, services delivered to Native Americans at Indian Health Service, tribal, or urban Indian clinics, chronic disease prevention and management programs and other care coordination programs, and emergency physician and hospital services.