Oklahoma Department of Human Services
Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd. • Oklahoma City, OK 73105
(405) 521-3646 • Fax (405) 521-6684 • Internet: www.okdhs.org
 
317:35-17-12. Certification for ADvantage program services
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Revised 6-25-12

(a) Application date.  If the applicant is found eligible for SoonerCare, certification may be effective the date of application. The first month of the certification period must be the first month the member was determined eligible for ADvantage, both financially and medically.

  • (1) As soon as eligibility or ineligibility for ADvantage program services is established, the worker updates the computer form and the appropriate notice is computer generated to the member and the ADvantage Administration (AA).  Notice information is retained on the notice file for county use.
  • (2) An applicant approved for ADvantage program services is mailed a Medical Identification Card.

(b) Financial certification period for ADvantage program services. The financial certification period for the ADvantage program services is 12 months.  Although "medical eligibility number of months" on the computer input record will show 99 months, redetermination of eligibility is completed according to the categorical relationship.

(c)  Medical Certification period for ADvantage program services. The medical certification period for ADvantage program services is up to 12 months.  Redetermination of medical eligibility is completed by OKDHS in coordination with the annual reauthorization of the member's service plan.  An independent redetermination of medical eligibility is completed by the OKDHS Nurse when, depending upon the needs of the member, the medical certification is determined to be less than 12 months, or, at any time documentation supports a reasonable expectation that the member may not continue to meet medical eligibility criteria.

 

Last Updated:  7/11/2012