Note: If you have not created your personalized site key token, you will be asked to do so before you sign into the SoonerCare Portal.
This global is to inform providers that effective November 1, 2016 the Oklahoma Health Care Authority (OHCA) Medical Authorization Unit (MAU) will require prior authorization (PA) requests to be initiated electronically through the SoonerCare Provider Portal. After initiation of the PA request, providers may submit the necessary clinical records, photos and supporting documentation electronically. The OHCA prefers all documentation to be uploaded electronically, but will continue to accept documentation by fax or mail through June 30, 2017. However, by July 1, 2017, OHCA intends to transition to an electronic PA submission process inclusive of documentation consistent with OHCA's commitment to going "green" and reducing costs. OHCA will provide additional information as this process progresses.
This November 1, 2016 transition for PA requests to be initiated electronically through the SoonerCare Provider Portal will now include the following five areas: Spine Procedures, Joint Procedures, Cardiology Procedures, Pain Management and Radiation Therapy. Please note that this November 1, 2016 transition does not include dental, pharmacy or behavioral health PAs.
A provider letter outlining this change and providing additional information will be sent soon and will also be found at: www.okhca.org/providerletters. Please consider signing up for "WebAlerts" on this page to be notified when this and other new Provider Letters are posted.
We will also be offering provider training to help prepare for this change. A global message with more detailed information about the training will also be posted soon.
If you need assistance with reviewing your prior authorizations online or submitting your clinical documentation or prior authorizations electronically, please call the SoonerCare Helpline at (800) 522-0114. Thank you for your continued support of our SoonerCare program
Registration for the October 5-6, 2016 Fall Workshop in Tulsa will close on Wednesday, September 28 at 5 p.m. However, walk-ins are still welcome! Please come 15-20 minutes before the first class you wish to take and bring your Provider ID. Registration for OKC and Guymon is still available. Register today! Information and registration is available at:
Class Descriptions: http://www.okhca.org/Classes Registration Tool: http://www.okhca.org/Register
To make any changes to your registration, please call 405.416.6730 or email HPokxixTraining@hpe.com
All SoonerCare providers and staff are encouraged to attend the 2016 Fall SoonerCare Provider Training Workshops hosted by the OHCA and HPE.
Classes include:Understanding and Implementing CMS Ordering and Referring Guidelines; Effective Provider Portal Solutions; EDI Toolbox; Prior Authorizations on the Provider Portal; Automated Patient Dismissal Process; DMEPOS Updates; SoonerCare Pharmacy Program Overview; SoonerCare Update and Navigating the Public Website; and EHR Incentive Program.
Class descriptions explain the covered topics and recommended audience. The workshops will be held at five locations statewide, beginning September 22nd.
Class Descriptions and Registration information:
Physician contracts expire September 30, 2016, but the renewal process begins July 18th. To avoid any delay in reimbursement, we encourage physicians to begin their renewals as soon as possible starting July 18.
What can you do in the Soonercare Provider Portal
The Oklahoma Health Care Authority's secure portal is intended for providers, clerks and billing agents. This site gives you the opportunity to maintain provider information, access claim and prior authorization related functions, and receive messages from the OHCA that apply specifically to you.