HealthChoice introduces HealthSCOPE

Posted on: 10/11/17

Leaders of Oklahoma’s Employees Group Insurance Division (EGID) met Tuesday at OHA with the Oklahoma Hospital Managed Care Association and introduced HealthSCOPE Benefits, the firm that will administer claims in 2018 for the state’s HealthChoice plan. HealthSCOPE will also handle claims for the state Department of Corrections and Department of Rehabilitation Services.

HealthSCOPE Benefits is the fourth largest third party administrator (TPA) in the country, working for plans covering 500,000 members in all 50 states. EGID’s claims will be processed by HealthSCOPE in Columbus, Ohio. The company is hiring 40 employees dedicated to Oklahoma providers.

HealthScope will handle all claims for services provided Jan. 1, 2018 and after. The current HealthChoice third party administrator, DXC Technology (previously known as HP Enterprise, HP, and EDS), will continue to accept and pay claims for services incurred prior to Jan. 1, 2018. DXC will transfer all open certifications for services to HealthSCOPE as of Jan. 1.

Payments and supporting detail will be delivered to providers by ECHO Health. Providers can receive these by electronic funds transfer (EFT) or paper check.

EGID has set up a “New Medical and Dental Claims Administrator” page in the Provider section of their website, and will be adding information to this page in coming weeks.

An upcoming edition of the HealthChoice “Network News” will include detailed information about EGID’s transition to HealthSCOPE. (Rick Snyder)