The Medicaid Provider Profile page shows the Medicaid services provided by your facility, along with the values and effective dates of Medicaid reimbursement calculations.
- To access the Medicaid Provider Profile page, select Go To > Government Payor Research > Medicaid > Provider Profile. The Medicaid Provider Profile page opens.
- In the Select State or Payer drop down list, select OK.
- Select Go.
- Enter the provider’s tax ID or ten-digit National Provider Identification (NPI) number for the provider you want to review in the NPI or Provider Number field.
- Enter a date in the Effective Date field if you want to view provider profile information for an effective date other than today.
- Click Display Profile. The Medicaid Provider Profile information displays.
Note: To clear the results and return to original Medicaid Provider Profile page, click Reset.
- Review your Medicaid Provider Profile information.
Note: The data that displays on the provider profile varies from state to state.
Oklahoma Medicaid Provider Profile
The following table describes each of the fields on the Medicaid Provider Profile page for Oklahoma Medicaid.
|
Field |
Description |
|
State or Payer |
State or payer for the selected provider number |
|
NPI or Provider Number |
Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims |
|
Effective Date |
Date on which the selected profile went into effect |
|
Inpatient Hospital |
|
|
Inpatient Base Rate |
Base rate for inpatient services as determined by the Oklahoma administrative code |
|
Cost-to-Charge Ratio |
The ratio for determining hospital cost based on charges |
|
Inpatient Outlier Cap Rate |
Cost threshold amount used in the cost outlier calculation |
|
Outlier Adj Factor Ratio |
Outlier adjustment factor ratio used in the cost outlier calculation |