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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 317. Oklahoma Health Care Authority |
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Chapter 30. Medical Providers-Fee for Service |
| Subchapter 1. General Provisions |
| SECTION 317:30-1-1. Purpose; use of manuals |
| SECTION 317:30-1-2. Authority responsibility; fiscal agent |
| SECTION 317:30-1-3. Description of rules |
| SECTION 317:30-1-4. Definitions |
| Subchapter 3. General Provider Policies |
| Part 1. GENERAL SCOPE AND ADMINISTRATION |
| Part 3. GENERAL MEDICAL PROGRAM INFORMATION |
| Part 4. EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT) PROGRAM/CHILD-HEALTH SERVICES |
| Part 5. ELIGIBILITY [revoked] |
| Part 6. OUT-OF-STATE SERVICES |
| Subchapter 5. Individual Providers and Specialties |
| Part 1. PHYSICIANS |
| Part 2. PHYSICIAN ASSISTANT |
| Part 3. HOSPITALS |
| Part 4. LONG TERM CARE HOSPITALS |
| Part 5. PHARMACIES |
| Part 6. INPATIENT PSYCHIATRIC SERVICES |
| Part 7. CERTIFIED LABORATORIES |
| Part 8. REHABILITATION HOSPITALS |
| Part 9. LONG-TERM CARE FACILITIES |
| Part 10. BARIATRIC SURGERY |
| Part 11. MATERNITY CLINIC SERVICES [revoked] |
| Part 12. THE OKLAHOMA PRESCRIPTION DRUG DISCOUNT PROGRAM |
| Part 13. HIGH RISK PREGNANT WOMEN CASE MANAGEMENT SERVICES [revoked] |
| Part 14. TARGETED CASE MANAGEMENT SERVICES FOR FIRST TIME MOTHERS AND THEIR INFANTS/CHILDREN [revoked] |
| Part 15. CHILD HEALTH CENTERS [revoked] |
| Part 16. MATERNAL AND INFANT HEALTH LICENSED CLINICAL SOCIAL WORKERS |
| Part 17. MEDICAL SUPPLIERS |
| Part 18. GENETIC COUNSELORS |
| Part 19. CERTIFIED NURSE MIDWIVES |
| Part 20. LACTATION CONSULTANTS |
| Part 21. OUTPATIENT BEHAVIORAL HEALTH AGENCY SERVICES |
| Part 22. HEALTH HOMES |
| Part 23. PODIATRISTS |
| Part 24. CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS |
| Part 25. PSYCHOLOGISTS |
| Part 26. LICENSED BEHAVIORAL HEALTH PROVIDERS |
| Part 27. INDEPENDENT LICENSED PHYSICAL THERAPISTS |
| Part 28. OCCUPATIONAL THERAPY SERVICES |
| Part 29. RENAL DIALYSIS FACILITIES |
| Part 31. ROOM AND BOARD PROVIDERS |
| Part 32. SOONERRIDE NON-EMERGENCY TRANSPORTATION |
| Part 33. TRANSPORTATION BY AMBULANCE |
| Part 35. RURAL HEALTH CLINICS |
| Part 37. ADVANCED PRACTICE REGISTERED NURSE |
| Part 39. SKILLED NURSING SERVICES |
| Part 41. FAMILY SUPPORT SERVICES |
| Part 43. AGENCY COMPANION, SPECIALIZED FOSTER CARE, DAILY LIVING SUPPORTS, GROUP HOMES, AND COMMUNITY TRANSITION SERVICES |
| Part 45. OPTOMETRISTS |
| Part 47. OPTICAL SUPPLIERS |
| Part 49. FAMILY PLANNING CENTERS [revoked] |
| Part 51. HABILITATION SERVICES |
| Part 53. SPECIALIZED FOSTER CARE |
| Part 55. RESPITE CARE |
| Part 57. HOSPICE CARE |
| Part 58. NON-HOSPITAL BASED HOSPICE |
| Part 59. HOMEMAKER SERVICES |
| Part 61. HOME HEALTH AGENCIES |
| Part 62. PRIVATE DUTY NURSING |
| Part 63. AMBULATORY SURGICAL CENTERS (ASC) |
| Part 64. CLINIC SERVICES |
| Part 65. CASE MANAGEMENT SERVICES FOR OVER 21 |
| Part 67. BEHAVIORAL HEALTH CASE MANAGEMENT SERVICES [revoked] |
| Part 69. CERTIFIED REGISTERED NURSE ANESTHETISTS |
| Part 70. ANESTHESIOLOGIST ASSISTANTS |
| Part 71. EARLY INTERVENTION CASE MANAGEMENT SERVICES |
| Part 73. EARLY INTERVENTION SERVICES |
| Part 75. FEDERALLY QUALIFIED HEALTH CENTERS |
| Part 77. SPEECH AND HEARING SERVICES |
| Part 79. DENTISTS |
| Part 80. MOBILE AND/OR PORTAL DENTAL TREATMENT FACILITIES |
| Part 81. CHIROPRACTORS |
| Part 83. THERAPEUTIC FOSTER CARE |
| Part 84. INTENSIVE TREATMENT FAMILY CARE |
| Part 85. ADVANTAGE PROGRAM WAIVER SERVICES |
| Part 87. BIRTHING CENTERS [revoked] |
| Part 89. RADIOLOGICAL MAMMOGRAPHER |
| Part 90. DIAGNOSTIC TESTING ENTITIES |
| Part 91. TUBERCULOSIS CLINIC SERVICES [revoked] |
| Part 93. CASE MAAGEMENT SERVICES FOR PERSONS INFECTED WITH TUBERCULOSIS [revoked] |
| Part 95. AGENCY PERSONAL CARE SERVICES |
| Part 99. CASE MANAGEMENT SERVICES FOR UNDER AGE 18 IN EMERGENCY, TEMPORARY OR PERMANENT CUSTODY OR SUPERVISION OF THE DEPARTMENT OF HUMAN SERVICES |
| Part 101. TARGETED CASE MANAGEMENT SERVICES FOR PERSONS WITH INTELLECTUAL DISABILITY AND/OR RELATED CONDITIONS |
| Part 103. QUALIFIED SCHOOLS AS PROVIDERS OF HEALTH-RELATED SERVICES |
| Part 104. SCHOOL-BASED CASE MANAGEMENT SERVICES |
| Part 105. RESIDENTIAL BEHAVIORAL MANAGEMENT SERVICES IN GROUP SETTINGS |
| Part 108. NUTRITION SERVICES |
| Part 109. DIABETES SELF-MANAGEMENT TRAINING |
| Part 110. INDIAN HEALTH SERVICES, TRIBAL PROGRAMS, AND URBAN INDIAN CLINICS(I/T/US) |
| Part 112. PUBLIC HEALTH CLINIC SERVICES |
| Part 113. LIVING CHOICE PROGRAM |
| Subchapter 7. Billing and Inquiries [revoked] |
| SECTION 317:30-7-1. Preparation of claims forms [revoked] |
| SECTION 317:30-7-2. Remittance statement [revoked] |
| SECTION 317:30-7-3. Electronic billing [revoked] |
| SECTION 317:30-7-4. Medicare crossover claims [revoked] |
| SECTION 317:30-7-5. Claim status inquiries [revoked] |
| SECTION 317:30-7-6. Policy questions [revoked] |
| SECTION 317:30-7-7. Medicaid provider file changes [revoked] |
| SECTION 317:30-7-8. Claim adjustments [revoked] |
| SECTION 317:30-7-9. Inquiry instructions/addresses for filing claims [revoked] |
| Appendix A. Risk Levels for Providers |
Note
[Authority: Long-Term Social Security Act; Federal Social Security Act, Title XIX; Titles XVIII and XIX; Child Health Act; Title V; Civil Rights Act of 1964; Rehabilitation Act of 1973 (Part 90); The Oklahoma Health Care Authority Act; Age Discrimination Act of 1975; Education Amendments of 1972, Title IX; P.L. 88-352; P.L. 93-112; P.L. 99-456; P.L. 111-456; 31 U.S.C.A. 6101; Presidential Executive Orders 11246, 11375, and 12549; 42 CFR, §§ 405.2426, 431.54, 416.30-49, 440.100, 440.130, 440.140, 440.170, and 442 (Subparts E and G); 45 CFR, Part 93; 10 O.S., §§ 175.1 and 1415.1; 56 O.S., §§ 162.3, 164(c), and 175; 59 O.S., § 567.3(4); 63 O.S., §§ 1-1901 et seq., 3241.6, and 5003 through 5016; 68 O.S., § 1305; Laws 2002, c.470; 1-1944 through 1-1949 of the Oklahoma State Statutes.]
[Source: Codified 7-27-95]