MedicaidPrior AuthMedium impact
Provider Letter 2022-09: RE: Out-of-State Prepayment Claims Review and Prior Authorization
Oklahoma SoonerCare·OK·Prior Authorization
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid (SoonerCare) will begin conducting prepayment claims reviews for out-of-state services starting July 1, 2022. Most out-of-state services require prior authorization, with exemptions for emergency care and providers within 50 miles of the Oklahoma border.
Action Required
By July 1, 2022: Billing team must obtain prior authorization for all SoonerCare out-of-state services except emergency care and services from providers within 50 miles of Oklahoma border. Reference OHCA Out-of-State Services Changes page for authorization submission details. Contact OHCA provider helpline at 800-522-0114 with questions. Claims without proper authorization may be denied during prepayment review.