Durable Medical Equipment
Family Planning Waiver
Long-Term Care and Waiver Services
Third Party Liability
Policies & Rules
I/T/U Public Notices
SoonerCare Fax Blasts
Guidelines For Making A Referral
All out of state referrals require prior medical review.
If the treatment facility where the member is inpatient can provide overnight accommodations for the escort, or if the escort chooses to stay onsite, then overnight lodging is not authorized.
Hospital Social Workers may continue to issue lodging and/or meals vouchers up to 14 days per medical stay (verification with member is required regarding number of days that they have been receiving lodging and /or meals services).
Lodging &/or Meals Voucher may be discontinued at any time if criteria for visitation is not met.
Lodging and/or Meals Authorization form (voucher)
Room and Board Providers (list of lodging providers)
If lodging and/or meals services are needed beyond 14 days per medical stay, a referral must be submitted to OHCA Care Management for review.
When submitting documents for a lodging and/or meals referral, documents are to be faxed for review 3 business days before the date lodging and/or meals services are needed; fax to OHCA Care Management – Attention: Social Services at 405-530-3217.
For Initial Referrals
Fax a completed SoonerCare Lodging &/or Meals Request form or member’s proof of appointment.
SoonerCare Lodging and/or Meals Request form (referral form)
Proof of appointment must include the member’s name, phone number and SoonerCare ID number; the date, check in time, and duration of the appointment or procedure.
For Extended Stays (submit referral at least 3 business days before the 14th day limit)
Fax an updated letter of medical necessity or the member’s most recent nursing progress notes/medical records. Include the anticipated length of stay.
Notify Care Management by phone or fax of the dates that the escort is requesting lodging and/or meals services, and how many days have already been approved for the member or escort.
For NICU, the escort’s visitation log is required. Visitation must total a minimum of 6 hours per 24 hours to be eligible for continued lodging and/or meals services. (also, see note below)
Meals will be reimbursed only if an overnight stay occurs and the stay meets the lodging criteria. OAC 317:35-3-2.
If the member and/or escort meets the criteria for lodging services and stays overnight, but does not receive SoonerCare assistance for lodging, then the member and/or escort may still be eligible for meals assistance/reimbursement.
The member and/or escort are not eligible for reimbursement for meals if the lodging provider submits a claim for meal reimbursement because they are providing meals/food to the member.
If criteria for lodging and/or meals services are met, then the escort for the NICU infant can be approved for the first 7 days. The escort must maintain a visitation log showing sign in/out times at the NICU.
Employee E-Mail Access
Oklahoma’s Medicaid Agency