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MedicaidAdministrativeMedium impact

Provider Letter 2021-10: Claims Processing System

Oklahoma SoonerCare·OK·Provider Letter
Effective date
Aug 27, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Oklahoma's Medicaid program (SoonerCare) is upgrading from Claim Check to Claims Xten™ system effective August 27, 2021. The new system will automatically correct certain billing errors (like age/gender-inappropriate codes) by replacing them with correct codes rather than denying claims, but providers must verify the corrections match their documentation.

Action Required

Action needed
By August 27, 2021: Billing team must establish new workflow to review all processed SoonerCare claims for automatic code corrections made by Claims Xten™ system. Verify that any replaced procedure codes match the actual procedures performed and documented. If corrections are inaccurate, void the claim and resubmit with correct codes. Train staff to expect fewer denials but more need for post-processing review.