Spring 2019

• Legislative update
• Fall Provider Training Workshops
• Did You Know?
• Note: Fall/Winter Agency Closures
• Is your patients' information up-to-date?
• The Easiest Path to Healthier Patients
• Answers to your most frequently asked questions
• In the news ...

Legislative update

The 20-member Health Care Working Group includes nine members of each chamber and two members of Gov. J. Kevin Stitt's administration, Deputy Secretary of Health and Mental Health Carter Kimble and Deputy Secretary of State Samantha Davidson.

The bipartisan working group is focused on developing a solution for improving Oklahomans’ access to health care.

8/14/2019 – Representatives from the Oklahoma State Department of Health and the Oklahoma Health Care Authority gave presentations on their respective roles in overseeing and encouraging healthy outcomes for all Oklahomans. OSDH highlighted the state's historically low national rankings and health outcomes. OHCA summarized the population currently covered by SoonerCare.

8/21/2019 – The working group focused on the Department of Corrections in the second meeting as it relates to Medicaid. Officials discussed health care costs and mental health for those who are incarcerated by DOC. The University Hospitals Authority and Trust gave a presentation on medical services provided to DOC by OU Medical Center. OHCA was also present and answered multiple questions from working group members.

8/28/2019 – Hudson College of Public Health gave numerous policy recommendations, and Stigler Health & Wellness Center discussed federally qualified health centers.

9/4/2019 – Deputy Secretary of Health Carter Kimble discussed Medicaid and numbers about Oklahoma’s insured and uninsured. The group also heard from Mostly Medicaid and Government Affairs and Innovation.

9/18/2019 – Duncan Regional Hospital President and CEO Jay Johnson and OU Medicine President and CEO Chuck Spicer presented their views on the state of health care access in Oklahoma. Dr. Kayse Shrum, president and CEO of OSU Health Sciences and dean of the College of Osteopathy, spoke of her center’s mission to educate primary care physicians, especially those in rural areas.

9/25/2019 – Representatives from the Chickasaw Nation's Division of Health and the Cherokee Nation’s Health Services gave an overview of the tribal health system and how it interacts with federal and state government.

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Fall Provider Training Workshops

Fall 2019 SoonerCare Provider Training Workshops dates and locations are listed below. Scheduled trainings will cover the Insure Oklahoma program, SoonerCare referrals, patient-centered medical homes, provider enrollment and contracting, claims resolution and promoting literacy in the well-child visit through the Reach Out and Read program.

OHCA encourages providers and their staff to attend a workshop near them:

• Oct. 9 & 10 – Tulsa
• Oct. 17 & 18 – Oklahoma City
• October 24 – Guymon

Please visit the OHCA training page for specific times and locations.

Registration, complete class descriptions as well as specific time and location information are available on our website.

We look forward to seeing you!

Don’t miss our Web Alerts. *Sign up to be notified about new SoonerCare training opportunities.

Did You Know?

Tips to make your life as a SoonerCare provider easier when submitting a prior authorization request (to prevent your request from being pended back to you for documentation)

• Member name and date taken should be on all photos, images and radiographs.
• If requesting a third year of orthodontic treatment, members must have had a cleaning within the past year. If a cleaning was provided by a dentist who is not a SoonerCare provider, please document the dentist's name and the date of service.
• Please ensure all forms are filled out completely: HLLD (DEN-6), Referral for orthodontics (DEN-2) and Caries Risk Assessment.

Did you know?  OHCA has a page devoted to dental services – it contains links to policy, the dental fee schedule, dental forms and other useful information.

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Note: Fall/Winter Agency Closures

OHCA offices will be closed on the following dates, as they are observed as holidays by the state of Oklahoma:

• Nov. 11 – Veterans Day
• Nov. 28 & 29, 2019 – Thanksgiving
• Dec. 24 & 25, 2019 – Christmas

We will be happy to assist you during our regular office hours.

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Is your patients' information up-to-date?

A valid Oklahoma mailing address is required for all SoonerCare members. During their office visits, please encourage members to update any changes to their address through the SoonerCare member portal (www.mySoonerCare.org). The process takes less than five minutes and helps prevent interruption of their benefits. You can download or order our new flyer (one side in English, one side in Spanish) to distribute in your office. Members can also update their contact information by calling the SoonerCare Helpline at 800-987-7767. Back to top

Visit OKhelpline.com for free promotional items to display in your office like posters, fact sheets, brochures and more.

The Easiest Path to Healthier Patients

What if there were a simple way to lessen the risk of life-threatening conditions like mouth and throat cancer, heart disease and Type 2 diabetes? It all starts with one conversation.

Start a Tobacco-Free Journey
Talk to your patients about quitting tobacco with the Oklahoma Tobacco Helpline. With 24/7 nonjudgmental support and fully customizable services, the helpline gives your patients the resources they need to quit.

Plus, when tobacco users combine medications with counseling, they’re twice as likely to quit. Whether you are prescribing NRTs or smoking cessation medications, the helpline offers additional support for your patients.

Discover Life-Changing Services
Encourage your patients to register for the helpline at 800-QUIT NOW or OKhelpline.com. In just a few minutes, they can set a quit date and create a customizable quit plan. With the help of a specially trained quit coach, they can sign up for coaching calls; helpful tips; and a two-week supply of patches, gum or lozenges.

All Oklahomans older than 13 are eligible for helpline services. Plus, additional resources are available to SoonerCare members, Native Americans and pregnant women.

Get Started
Want to jumpstart the dialogue? The helpline offers free promotional items like posters, fact sheets and brochures. Just visit OKhelpline.com.

OHCA Provider Helpline: 800-522-0114

Dental Prior Authorization Unit: 405-522-7401

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Information contained within is subject to change. Be sure to check OHCA Provider Letters, Global Messages and Web Alerts at www.okhca.org for the most up-to-date information.

Answers to your most frequently asked questions

1. Is it possible for a SoonerCare member to also have private insurance? Yes. If a member has third-party insurance, SoonerCare is the payer of last resort in most circumstances. 2. What information are health insurers required to share with state Medicaid agencies? States enact laws to comply with section 1902(a) (25) (I)(i) of the Social Security Act. This means upon request of the state, health insurers must provide information to determine during which period Medicaid beneficiaries may be (or may have been) covered by the health insurer. The insurer is also required to detail the nature of that coverage. This information includes, at a minimum, four data elements: the insured’s name, address, group or member ID number and periods of coverage. State laws determine exactly what information is required from the health plans. Health plans are to provide these files to state Medicaid programs so these programs can determine whether any third-party payers are liable for the medical items and services that were, or will be, delivered to a Medicaid beneficiary. In essence, the point of the information gathering is to ensure Medicaid benefits are paid correctly. In the case of health insurers who contract with a pharmacy benefit manager or other third-party administrator to administer the plan, states also must require these insurers provide the PBM or TPA with such information as may be necessary to enable that entity to furnish the state with the prescribed data, or deal with such inquiries directly without the aid of their PBM or TPA. 3. How far back can state Medicaid agencies go in requesting eligibility and coverage information from health insurers? The Deficit Reduction Act of 2005 requires states to have laws in effect that require health insurers to honor claims submitted by the Medicaid agency within three years of the date of service. More information about Medicaid and third-party resources is available from the federal Centers for Medicare & Medicaid Services. Back to top

In the news ...

Here are a few hot topics:

• Kids' bad breath linked to specific salivary enzyme
• Draft Research Plan for Prevention of Dental Caries in Children Younger Than Age 5 Years: Screening and Interventions
• CDC reports decrease in early childhood caries
• ADA Statement on Study in JAMA Pediatrics
• AAP continues to recommend fluoride following new study on maternal intake and child IQ

Editor’s note: The opinions in these articles are those of the author(s) and do not necessarily represent the views of SoonerCare Dental or the Oklahoma Health Care Authority. In addition, some of these articles may require registration or subscription to access. This listing is provided for informational purposes only.

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Our vision is for Oklahomans to be healthy and to have access to quality health care services regardless of their ability to pay.

OHCA Core Values:
Inclusiveness | Accountability | Engagement | Innovation | Integrity

The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.

Oklahoma Health Care Authority
4345 N. Lincoln Blvd.
Oklahoma City, OK 73105
www.okhca.org/dental-provider