Spring 2018 Provider Workshop

Child Abuse and Neglect: Recognition, Treatment and Long Term Consequences

Recommended Audience: Physicians, NPs, PAs

Description: This course is a review of the common presentations of child abuse and neglect for the medical provider. Included will be a discussion on what to do when child abuse or neglect is suspected and the long term outcomes and treatments.

Contact Information: Child Abuse and Neglect Physicians Network

Presentation: Child Abuse

Dental Policy and Prior Authorization

Recommended Audience: All dental providers and dental billing staff.

Description: A thorough look at current OHCA dental policy, coverage for new procedures, and how to submit a dental prior authorization (PA) on the SoonerCare Provider Portal.  

Presentation: Dental PA

DME 2018 Update

Recommended Audience: DME PA Processing Staff, Managers, and Owners

Description: Updates on pricing, processing and prior authorizations for DME PA processing staff, managers, and owners. 

Presentation: DME

Outpatient Behavioral Health Basics

Recommended Audience: This class will be appropriate for contracted outpatient behavioral health providers, i.e. outpatient agencies, behavioral health groups, and privately contracted LBHP’s.

Description: This class will review the SoonerCare Outpatient Behavioral Health Program.  It will include an overview of commonly asked questions by behavioral health provider type.

Presentation: Behavioral Health

Patient Center Medical Home

Recommended Audience: All SoonerCare Choice Patient-Centered Medical Homes.

Description: The class will cover recent updates to processes affecting SoonerCare Choice primary care providers including the PCP referral process, and other timely information.  It will also cover reminders concerning contract and tier requirements.

Presentation: PCMH

Prior Authorizations

Recommended Audience: All providers who request prior authorizations through the OHCA Medical Authorization Unit.

Description: This class will provide general information regarding the prior authorization process and an overview of the InterQual integration related to specific services. Prior authorization services related to Behavioral Health, DME, Pharmacy and Waiver are not included.

Presentation: Prior Auth

SoonerCare Solutions

Recommended Audience: All Providers

Description: The “SoonerCare Solutions” presentation captures some of the common hurdles providers face when submitting claims, prior authorizations, and sending supporting documentation. The presentation will also briefly cover areas of EDI, special claim processing, and provide suggestions that will aide providers in overcoming some of the most commonly seen obstacles.

Presentation: SC Solutions

SoonerRide Non-Emergency Transportation

Recommended Audience: All SoonerCare providers including case managers.

Description: This class will cover information concerning SoonerRide non-emergency transportation reservations, pharmacy stops and stretcher services.  It will also introduce a new service that allows providers to schedule SoonerRide services for their patients on-line through Facility TripCare Online Services.

Presentation: SoonerRide

TPL Simplified

Recommended Audience: All Provider Types who bill members with dual coverage.

Description: This course is an overview of Third Party Liability (TPL) according to OHCA policy.  Included in this presentation will be clarifying TPL, verifying eligibility, and filing claims for payment when a recipient is covered by a primary insurance.  In addition, this class will discuss updating a member’s TPL, Health Management Systems (HMS) potential third party liability projects, and connecting with resources for further inquiry.  

Presentation: TPL

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