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OKDHS Home > Library > Policy > OAC 317 > Chapter 45. Insure Oklahoma > 11. Insure Oklahoma/O-EPIC IP > 2. Insure Oklahoma IP provider payments
317:45-11-2. Insure Oklahoma IP provider payments
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Revised 6-25-11

    

     Payment for covered benefits rendered to Insure Oklahoma IP members is made to contracted Insure Oklahoma IP healthcare providers for medical and surgical services within the scope of OHCA's medical programs, provided the services are medically necessary as defined in 317:30-3-1(f).

  • (1) Coverage of certain services requires prior authorization and may be based on a determination made by a medical consultant in individual circumstances;
  • (2) The decision to charge a co-payment for a missed visit is at the provider's discretion;
  • (3) The provider may collect the member's co-payment in addition to the SoonerCare reimbursement for services provided; and
  • (4) The provider may refuse to see members based on their inability to pay their co-payment.


    

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Last Updated:  7/8/2011
Oklahoma Department of Human Services
Street address: Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd., Oklahoma City, OK 73105
Mailing address: P.O. Box 25352, Oklahoma City, OK 73125
(405) 521-3646
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