HIPAA claims

Oklahoma Health Care Authority Provider Portal Guides

Oklahoma Health Care Authority uses the SoonerCare Provider Portal offering providers several services from submitting claims on the web to fast verification of claim status. The SoonerCare Provider Portal is available 24 hours a day, 7 days a week, except during scheduled maintenance. Find the types of Web Users below.

Providers

Providers will receive a letter by email containing the provider’s access PIN. This PIN, used in conjunction with the Provider ID, will grant the provider initial access to the SoonerCare Provider Portal. Only providers with an active SoonerCare contract will receive a PIN letter. Separate PIN letters will be mailed to each location. It is recommended that providers initialize their account and immediately create users (clerks) that will be used to operate the Internet application daily. Operating daily under the master user (Provider) poses certain security risks and should only be used when managing the account.

Billing Agents

Billing agents are given logon credentials directly from Gainwell. When users initialize their accounts, they will be prompted to establish a password, challenge questions and answers, site key token and contact information upon initializing their accounts. Billing Agents do not have the ability to create, grant access to, or revoke permissions of other users.

Clerks

The provider or billing agent who created the clerk will give clerks logon credentials. Users will be required to establish a password, challenge questions and answers, site key token and contact information upon initializing their accounts. Clerks do not have the ability to create, grant access to, or revoke permissions of other users.

Enrollment Agents

Each provider can assign one (1) active clerk to be their enrollment agent. In addition to their other functions, this enrollment agent will have access to renew or make changes to the provider’s contract with OHCA; including licensing information, banking details, and ownership information where applicable.

To learn more about EDI and become a certified EDI Professional, please visit our course schedule page.

Leave a Reply

Your email address will not be published.

Post Navigation