Prior Authorization changes coming to SoonerCare

Posted on: 4/12/17

Oklahoma’s Medicaid program is changing its process for prior authorization (PA) requests on July 1.  PA requests will be initiated online through the SoonerCare Provider Portal using the “Medical” radio button. This new process includes the upload of clinical documentation. PA status notifications will continue to be available through the SoonerCare Provider Portal.

The change will not apply to behavioral health PAs.

Also effective July 1, the Oklahoma Health Care Authority (OHCA) will assume responsibility for the review of SoonerCare imaging and therapy PAs. Their vendor, eviCore, will no longer provide these services.

See OHCA Provider Letter 2017-07 for information on the Prior Authorization changes.

OHCA will cover these PA changes and more during their 2017 Spring SoonerCare Provider Training Workshops, which will be held: Lawton - April 13; Durant - April 27; Tulsa - May 17 & 18; Oklahoma City - May 24 & 25.

To register for the workshops, please visit the OHCA Provider Training page.

OHA Partners with Qualivis 

Qualivis was developed as a collaborative effort among multiple state hospital associations to meet the temporary staffing needs of member hospitals and health systems.

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