HealthChoice changing certification and hospital transfer policies

Posted on: 5/3/17


HealthChoice, the state of Oklahoma’s health plan for state and education employees, is updating its certification (authorization) requirements for imaging and pacemaker/defibrillator procedures.  

Effective July 1, 2017, HealthChoice will required certification for all CT scans, MRIs, MRAs, PETC, SPECT, and outpatient pacemaker/defibrillator procedures.

For a list of the codes added to the certification requirement, click here.

Questions should go to the HealthChoice certification administrator, at (800) 848-8121. To view the HealthChoice Provider Manual page on certification, click here.

Also effective July 1, 2017, HealthChoice will change their calculation of the allowable fee paid to facilities transferring an inpatient to another hospital. The formula for the fee will be: (MS-DRG allowable fee/geometric mean length of stay) x (length of stay + 1 day).

The total transfer allowable fee paid to the transferring facility is capped at the amount of the MS-DRG allowable fee for a non-transfer case. HealthChoice will allow payment to the receiving facility, if it is also the final discharging facility, at the MS-DRG allowable fee as if it were an original admission. (Rick Snyder)

Save the dates for OHA 2022 events

Posted on: 2/18/22


It’s a new year and a new lineup of important events for you and your staff. Don’t miss out on these opportunities to engage in advocacy, education and networking all year long. Mark your calendar now!

OHA Advocacy Day - Tuesday, April 5, Oklahoma History Center. Join us for our annual legislative day. We will begin with a member briefing at 3 p.m., followed by a legislative reception at 5 p.m. Watch for registration materials soon.

OHA-PAC Golf Tournament - Tuesday, June 21, Jimmie Austin Golf Club at OU, Norman. Time and details TBA.

OHA Health Care Leaders Forum - Tuesday, July 19 - Thursday, July 21, Shangri-La Resort, Grand Lake. Watch for registration soon!

OHA Connect 22 - Wednesday, Nov. 9 - Friday, Nov. 11, Oklahoma City Convention Center and Omni Hotel, downtown Oklahoma City. Plan now to attend OHA’s annual conference and exhibit hall. More details to come.

Details on these events and other upcoming education opportunities will be available on the OHA website.