Oklahoma Administrative Code (Last Updated: March 11, 2021) |
TITLE 317. Oklahoma Health Care Authority |
Chapter 30. Medical Providers-Fee for Service |
Subchapter 5. Individual Providers and Specialties |
Part 22. HEALTH HOMES |
SECTION 317:30-5-253. Reimbursement
Latest version.
- (a) In order to be eligible for payment, HHs must have an approved Provider Agreement on file with OHCA. Through this agreement, the HH assures that OHCA's requirements are met and assures compliance with all applicable Federal and State regulations. These agreements are renewed annually with each provider.(b) A Health Home may bill up to three months for outreach and engagement to a member attributed to but not yet enrolled in a Health Home. The reimbursement for outreach and engagement is limited to once per month and is not reimbursable in the same month that the HH receives reimbursement for qualified HH services.(c) The HH will be reimbursed a monthly care coordination payment upon successful submission of a claim for one or more of the covered services listed in 317:30-5-251.