OKLAHOMA DEPARTMENT OF HUMAN SERVICES
Developmental Disabilities Services Division
Sequoyah Building, 2nd Floor
P.O. Box 25352
Oklahoma City, OK  73125-0352
(405) 521-3571
November 22, 2016

Re: OHCA Letter 2016-25

Dear Providers, Guardians/Family and Service Recipients,

The purpose of this letter is to provide additional guidance for provider letter 2016-25 issued by the Oklahoma Healthcare Authority on August 16, 2016.

The above referenced letter identified that all claims for reimbursement of items and/or services ordered or referred contain the National Provider Identifier (NPI) of the physician or other professional who ordered, referred, and/or provided such items or services.  What this means is beginning October 1, 2016, all claims for the services mentioned above will require entry of the NPI or they will be denied.  The physician or other professional who ordered or referred items and/or services MUST have a current Medicaid/SoonerCare contract. 

How will this affect services for my client, family member or myself? 

• Providers- if you currently have an authorization in place ordered or referred by a physician or other professional who no longer contracts with Medicaid/SoonerCare, you need to contact the service recipients Case Manager.
  
• Guardian/family/self- if you or your loved one is receiving services ordered or referred by a physician or other professional who no longer contracts with Medicaid/SoonerCare, you will need to choose a new physician or other professional who does contract with Medicaid/SoonerCare.

These changes went into effect October 1, 2016.  As a result, you need to take action now to ensure services are not interrupted.  If you have any questions contact your case manager. 

Very truly yours, 

Marie Moore

Interim Division Director
Developmental Disabilities Services Division
Oklahoma Department of Human Services