Spring 2017 Provider Workshop

Beyond 101

Recommended Audience: All medical and clinical providers, including front desk personnel, office administrators and all members of the health care team

Description: An in-depth look at the SoonerCare Provider Portal. Get helpful hints for claim submission, prior authorizations and additional aspects of the SoonerCare program.

Presentation: Beyond 101

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

Health Literacy

Recommended Audience: All medical and clinical providers, including front desk personnel, office administrators and all members of the health care team

Description: One size DOES NOT always fit all, especially when it comes to communicating with members about health information. Gain a better understanding of how health literacy can impact a member’s knowledge in accessing health information, following dosage instructions, making informed health decisions, and using medical tools for personal and family health care. This course challenges you to think about the significance of health literacy in the work you do and expand your approach to practicing health literacy in daily activities.

Presentation: Health Literacy

Lead Poisoning Prevention 101

Recommended Audience: Providers and groups that work with small children (under age 6)

Description: All children are required to have blood lead testing at 12 months and 24 months. This class focuses on the importance of obtaining blood lead test screenings, the type of follow-up required for children, and important information to give to parents. We also provide an opportunity for providers to ask questions concerning the Oklahoma Childhood Lead Poisoning Prevention Program (OCLPPP).

Presentation: Lead Poisoning Prevention

Medical Authorization Tips

Recommended Audience: Provider staff members who process PAs, as well as billing managers

Description: Learn how to maximize the provider portal for prior authorization submission. You will also get tips for utilizing prior authorization (PA) search, treatment history and uploading documentation.

Presentation: Medical Authorization Tips

SoonerCare 101

Recommended Audience: Introduction to SoonerCare benefits for new providers and serves as a refresher for current billing staff

Description: A discussion of covered services for SoonerCare adults and children, additional programs supported by OHCA, and general policy information.

Presentation: SoonerCare 101

SoonerCare Changes and Updates

Recommended Audience: All SoonerCare providers

Description: Everything primary care and specialty providers should know about important changes to the electronic referral process. We cover updates in the SoonerCare Choice program including the patient-centered medical home (PCMH) redesign, SoonerHealth (aged, blind and disabled care coordination), behavioral health screenings and more.

Presentation: SC Changes and Updates

Third Party Liability Logistics

Recommended Audience: Billing providers who accept primary insurance in addition to SoonerCare

Description: Learn how to bill claims when SoonerCare is secondary to private insurance (Medicare and HMOs). This includes how to bill SoonerCare with TPL through Electronic Data Interchange (EDI), the Provider Portal and on paper.

Presentation: TPL Logistics

Upper Payment Limit Program (UPL)

Recommended Audience: Hospitals and nursing homes

Description: The Upper Payment Limit (UPL) Program will oversee an integrated supplemental payment system to enhance functionality, care management, and decrease return to acute care days (RTA). Get an overview of the UPL Program, details on how to participate, and other valuable information.

Presentation: Upper Payment Limit Program

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