HealthChoice TPA Updates

Below is the first edition of the HealthChoice TPA updates. In this edition you will find important information related to claims addresses, payer ID and contact numbers. Updates will be sent out weekly detailing additional subjects as they relate to the Jan. 1, 2018, change (all articles with new information will be titled HealthChoice TPA Updates).
 
Be sure to watch your mail and email, and the provider website at https://www.ok.gov/sib/Providers/New_Medical_and_Dental_Claims_Administrator.html.

New Medical and Dental Claims Administrator

HealthChoice, Department of Corrections, and Department of Rehabilitation Services are excited to announce they will have a new third-party medical and dental claims administrator effective Jan. 1, 2018. The current claims administrator will continue to pay claims and answer questions related to services incurred during 2017 and prior. Providers should continue to submit claims electronically or on paper utilizing acceptable clearinghouses with payer ID 22521 until Jan. 1, 2018. Claims with dates of service on or after Jan. 1, 2018, should be submitted to the new claims administrator. HealthChoice members will receive new ID cards for the 2018 plan year that will reflect the updated payer ID, phone numbers and claims addresses for the new TPA.

The new medical and dental claims administrator is the fourth largest TPA in the country, paying almost $1.5 billion in claims for approximately 500,000 members in 2016. Claims turnaround in the same year averaged 3.57 days with 99.65 percent accuracy. Average answer speed in the call center is 19.65 seconds with 97 percent of customer inquiries resolved during the first call. The claims administrator currently covers over 5,000 lives in Oklahoma through Adventist Risk Management, Accident Care and Treatment, Owens Corning, OK Foods, SLPT Global Pump, and Fidelity Communications. Other large plans outside of Oklahoma include the State of Nevada and Whirlpool.

HealthChoice, Department of Corrections, and Department of Rehabilitation Services will have specific tracking for provider issues during the transition, and communications to providers will occur often. Be sure to watch for notices via mail and email and check our website at www.sib.ok.gov frequently for updates. Providers should share these notices with their registration, scheduling and business office staff.

HealthChoice, Department of Corrections, and Department of Rehabilitation Services are dedicated to making this a smooth and seamless transition. Please do not hesitate to call EGID Network Management with any questions at 405-717-8790 or toll-free 800-543-6044. 

	CLAIMS WITH DOS PRIOR TO 01/01/18 CURRENT TPA	CLAIMS WITH DOS AFTER 01/01/18 NEW TPA
PHONE	HealthChoice:    Toll-free 800-782-5218 Department of Corrections:    Toll-free 800-262-7683 Department of Rehabilitation Services:    Toll-free 800-944-7938	HealthChoice:    Toll-free 800-323-4314 Department of Corrections:    Toll-free 800-323-3710 Department of Rehabilitation Services:    Toll-free 800-285-6815
FAX	405-416-1790	Toll-free 800-496-3138
TTY	405-416-1525 or Toll-free 800-941-2160	711 or Toll-free 800-545-8279
CLAIMS ADDRESS	HealthChoice P.O. Box 24870 Oklahoma City, OK 73124-0870 Department of Corrections P.O. Box 268928 Oklahoma City, OK 73126-8928 Department of Rehabilitation Services P.O. Box 25069 Oklahoma City, OK 73125-5069	HealthChoice P.O. Box 99011 Lubbock, TX 79490-9011 Department of Corrections P.O. Box 16532 Lubbock, TX 79490-6532 Department of Rehabilitation Services P.O. Box 16485 Lubbock, TX 79490-6485
CORRESPONDENCE ADDRESS	HealthChoice, DOC, DRS P.O. Box 24110 Oklahoma City, OK 73124-0110	Same as claims address above
PAYER ID	HealthChoice, DOC, DRS: 22521	HealthChoice: 71064 Department of Corrections: 71065 Department of Rehabilitation Services: 71065

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