SECTION 317:45-11-2. Insure Oklahoma Individual Plan (IP) provider payments

Latest version.

  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 Oklahoma Administrative Code 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; and
(2)   The provider may collect the member's co-payment in addition to the SoonerCare reimbursement for services provided.

[Source: Added at 24 Ok Reg 101, eff 8-2-06 (emergency); Added at 24 Ok Reg 963, eff 5-11-07; Amended at 26 Ok Reg 2169, eff 6-25-09; Amended at 27 Ok Reg 2391, eff 7-1-10 (emergency); Amended at 28 Ok Reg 1574, eff 6-25-11; Amended at 37 Ok Reg 1669, eff 9-14-20]

                    
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