Oklahoma

To calculate an Oklahoma Medicaid claim at 100% of the state regulation rates, use the default settings for all pre-filled fields.

  • For ASC providers, type the preferred provider number in the Override OP ASC Provider Number field.
  • For Inpatient Per Diem Providers, type the preferred inpatient per diem provider number in the Override Inpatient Per Diem Provider Number field.
  • For all other providers, type the preferred provider number in the Override Provider Number field.

All of the remaining fields are required.

Note: Refer to the contract to determine the options to select and the values to enter.

The following table describes the fields on the OK tab of the Medicaid - Facility reimbursement tool.

Field

Description

Do not consume charges

Provides the option not to consume charges. This is used for contract carve outs.

Do not consume units

Provides the option not to consume units. This is used for contract carve outs.

Override Inpatient Per Diem Provider Number

Preferred inpatient per diem provider number. Up to ten numeric digits.

Override OP ASC Provider

Preferred Outpatient ASC provider number. Up to ten alphanumeric digits.

Override Provider Number

Preferred provider number. Up to ten alphanumeric digits.

Override Service Date

Preferred service date. Use MM/DD/YYYY format. Overrides the service date on the claim with the date you enter. You may use the anchor date instead of this option.

Percent Reimbursement

Three digit percentage amount.

State Code

This field defaults to OK, and it cannot be changed.

Use Insure Fee Schedule

This default for this check box is unchecked. When unchecked, OP claims process using FFS fee schedule. When checked, OP claims process using Insure Fee Schedule.