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317:30-5-96.8.Psychiatric Residential Treatment Facility payments to subcontractors

[Issued 02-01-08]
(a) Psychiatric Residential Treatment Facilities (PRTFs) that receive a pre-determined all-inclusive per diem payment must provide routine, ancillary and professional services. In the event the member receives an ancillary service, the PRTF is responsible for making timely payment to the subcontractor or other provider.
(b) For purposes of subsection (a) of this Section, timely payment or adjudication means payment or denial of a clean claim within 45 days of presentation to the PRTF.
(c) No subcontractor of the PRTF may charge more than the OHCA fee schedule for SoonerCare compensable services.
(d) The subcontractor may not bill the SoonerCare member until the PRTF has refused payment.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.