Electronic Transactions

Oklahoma Complete Health is committed to providing our participating providers with the best tools possible to support their administrative needs. Our electronic transactions capabilities will speed up the processing and payment of your claims.

Secure Web Portal

Some of the functions available to you on the secure web portalExternal Link include:

Verify member eligibility and benefits
Check and submit claims
Submit and confirm authorizations

PaySpan

Oklahoma Complete Health and PaySpan are in partnership to provide an innovative web-based solution for Electronic Funds Transfers (EFT’s) and Electronic Remittance Advices (ERA’s).

PaySpan LoginExternal Link

EDI

Electronic Transactions (EDI) support for HIPAA transactions is provided for the health plan by Centene Corporation. Centene is currently receiving professional, institutional, and encounter transactions electronically, as well as generating electronic remittance advice (ERA/).

The following list contains contact information for the trading partners currently active with our health plan. All providers are encouraged to contact one of these trading partners to utilize our electronic transaction options. Our preferred EDI gateway is Availity. If you need assistance in making a connection with Availity or have any questions, please contact Availity Client Services at 1-800-282-4548.

Contact information for trading partners
CLEARINGHOUSE	SOONERSELECT MEDICAID AND CHILDREN'S SPECIALTY PROGRAM	WEBSITE	CONTACT PHONE NUMBER
Ability	68069*	Link to Ability website: www.abilitynetwork.comExternal Link	1-877-340-5610
Availity	68069*	Link to Availity website: www.availity.com/contact-usExternal Link	1-800-282-4548

CC.PP.500	3 Day Payment WindowExternal Link
CC.PP.065	Multiple Diagnostic Cardiovascular Procedure Payment Reduction (MDCR)External Link
CC.PP.068	Multiple Procedure Payment Reduction (MPPR) for Therapeutic ServicesExternal Link
CC.PP.069	Multiple Procedure Reduction: OphthalmologyExternal Link
CC.PP.061*	Non-Obstetrical Pelvic and Transvaginal UltrasoundsExternal Link
CC.PP.071	Office Visits Billed with Treatment Rooms
CC.PP.067	Renal HemodialysisExternal Link
CC.PP.050	Robotic SurgeryExternal Link
CC.PP.035	Sleep Studies Place of ServiceExternal Link
CC.PP.056	Urine Specimen Validity TestingExternal Link
CC.PP.502	Wheelchair AccessoriesExternal Link
CC.PP.501	30 Day ReadmissionExternal Link
CC.PP.066	Leveling of Care: Evaluation and Management OvercodingExternal Link
CC.PP.053	Non-Emergent ER Services (fka Leveling of ER Services)External Link
CC.PP.054	Physician's Consultation ServicesExternal Link
CC.PP.055	Physician's Office Lab Testing (POLT)External Link
CC.PP.057	Problem-Oriented Visits with Preventative VisitsExternal Link
CC.PP.052	Problem-Oriented Visits with Surgical ProceduresExternal Link

Last Updated: 09/16/2024