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Library: Policy

317:35-9-75. Certification for long-term medical care through ICF/IID, HCBW/IID services and to persons age 65 and older in a mental health hospital

Revised 9-14-18

(a) Application date. If the applicant is found eligible for SoonerCare, certification may be made retroactive for any service provided on or after the first day of the third month prior to the month of application and for future months. The first month of the certification period must be the first month that medical service was provided and the recipient was determined eligible.  1

(b) Certification period for long-term medical care. A certification period of twelve (12) months is assigned for an individual who is approved for long-term care.  2


Issued 1-15-19

1. The Oklahoma Health Care Authority (OHCA) no longer issues or prints copies of medical identification (ID) cards. Providers verify a member's eligibility by accessing the Eligibility Verification System, also known as the "Provider Network," at through the Provider Portal. When members need a physical card for community resources purposes:

(1) Online Enrollment members may log on to their Online Member Account and print the card; and

(2) Non-Online Enrollment members may contact the local Oklahoma Department of Human Services (DHS) county office to obtain a printed version of the card. DHS staff enters the member’s information into the Eligibility tab on the Medicaid Management Information System (MMIS) Extranet and clicks on the link "Display Member ID Card" to print a copy of the front and back of the medical ID card.

2. Refer to Quest article

for correct level of care coding instructions.
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