Section 13d reporting requirements need updating


05-Sep-2017 07:36

Starting January 1, 2018, the Oklahoma Health Care Authority (OHCA) will only pay care coordination fees for members that have had a visit with their assigned provider.This includes Insure Oklahoma providers and their assigned members as well.Adult dental coverage is outlined in OHCA policy 3-5-696(1) Effective November 1, 2017, adult dental services are limited to emergency extractions and the following: Payment is made for dental services set forth in this section.Tooth extraction must have medical need documented.More information about CHIP and these programs is available at If your patients have questions, please refer them to the website for the latest news and updates. Title: Dear Provider Letter 2017-35 Provider Letter 2017-35 serves to inform providers about the implementation of Inter Qual guidelines in the prior authorization request process.More details about Inter Qual Connect are forthcoming.Adult Dental Emergency Extractions Policy Change At their September meeting, the Oklahoma Health Care Authority’s Board of Directors voted unanimously to approve rule revisions that clarify dental coverage for adults.

Title: Potential Member Eligibility Changes The Oklahoma Health Care Authority (OHCA) wants to inform you of the possibility that any patients you have enrolled in Soon-To-Be-Sooners or who are covered under Insure Oklahoma Employer Sponsored Insurance (ESI)-dependent child, your patients might have changes in their eligibility in the coming months. As of the date of this letter, re-authorization has not occurred.Please post all comments by close of business Monday, October 16, 2017, via the Oklahoma Health Care Authority Policy Change Blog. Long-term care provider cost reports for SFY17 are due by 10/31/17.Facilities may be subject to a rate reduction equal to the amount of the direct care portion of the daily rate ranging from .56 to .06 per patient day, if cost reports are not received in a timely manner.(ii) Limited oral examinations and medically necessary images associated with the emergency extraction or with a clinical presentation with reasonable expectation that an emergency extraction will be needed.

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(iii) Smoking and Tobacco Use Cessation Counseling; and (iv) Medical and surgical services performed by a dentist or physician to the extent such services may be performed under State law when those services would be covered if performed by a physician.

Please post all comments by close of business Monday, November 6, 2017, via the Oklahoma Health Care Authority Policy Change Blog.