OKLAHOMA CITY (KFOR) – Some Oklahoma health care providers say they are seeing challenges in rolling out SoonerSelect despite reassurances from the Oklahoma State Department of Health Services (OHCA) that things are going well. some told News 4.
Sooner Select on Monday launched a new privatization approach for the more than 1 million vulnerable Oklahomans who rely on Medicaid.
The three programs that qualifying Oklahomans selected or were assigned to are:
- Aetna Better Health, Oklahoma: 844-365-4385, AetnaBetterHealth.com/Oklahoma
- Humana Healthy Horizons: 855-223-9868, Humana.com/Medicaid/Oklahoma
- Oklahoma Complete Health: 833-752-1664, OklahomaCompleteHealth.com
“In theory, I think it's probably a good idea, and if it works as expected, it would benefit patients and providers overall,” said LaCresha Harris, RN clinical manager at First Choice Pediatrics in Edmonds. I think it will be possible,” he said.
Harris said her clinic has reassigned most of its patients to other providers since the program was introduced on Monday.
“They're getting a new card in the mail from their new pediatrician,” Harris said.
She said her clinic typically survives on down payments, which are paid in advance based on the number of patients. However, with the current list, she only receives 10% of the regular payment.
“Our monthly payments are right around $3,000, so that’s a big difference,” Harris said.
News 4 reached out to OHCA for clarification about Harris' experience.
A spokesperson said the agency is working with three contracted entities to ensure all PCP information and provider directories are up to date.
It said incentive payments will be made on April 17 and reflect data from April 1. Providers were notified of the payment schedule last week, he said.
Harris told News 4 he's not sure the program was ready to start regardless.
“I don’t think we were quite ready to roll that out from the state level, especially three days ago,” Harris said. “And we're starting to see evidence to support that. There's no benefit to providers right now.”
Josh McDowell, a licensed professional counselor at Shisawtail Therapies in Moore, told News 4 on Thursday he was also frustrated by the development.
“We have to choose between helping people on Medicaid and working with people who really need it, or doing what families need,” McDowell said.
McDowell feels like some providers are being left with no record of how to properly bill for their services, with promises of a 90-day continuation period to ensure providers are paid. Despite this, he said he was worried about the future.
“Even just the most basic information about how to bill,” McDowell said. “There are still parts left.” [provider] Manuals that are still unresolved, don't exactly make sense, or contradict each other. ”
An OHCA spokesperson told News 4 that if providers need assistance or are confused about coverage or procedures, they can contact OHCA at 800-522-0114 or SoonerSelect@okhca.org he said.
OHCA also provided the following statement in hopes of addressing other concerns.
OHCA understands the questions that providers and members may face as SoonerSelect rolls out, and has been working closely with providers and all three SoonerSelect contractors for several months to conduct multiple provider education sessions. Ta. OHCA is actively working with CE to ensure providers and members have the support they need and to further educate providers on the new process. There is a 90-day continuity of care period, and to allow time for providers to transition to the new system and to ensure members receive the care they need, CE will be able to maintain existing All approvals must be complied with. OHCA prioritizes the health of its members and providers and holds each CE accountable for ensuring compliance with state, federal, and contractual obligations.
Oklahoma State Department of Health
