Manuals, Forms and Resources
Manuals
- Provider Manual (PDF)
- Provider Billing Manual (PDF)
- Provider Orientation Materials (PDF) - coming soon
Forms
Oklahoma Complete Health Forms
- Notification of Pregnancy (NOP) Letter and Form
- Outpatient Medicaid Prior Authorization Form (PDF)
- Inpatient Medicaid Prior Authorization Form (PDF)
- Provider Appeal Form (PDF) - This form is to be used for appeals where the service has already been rendered and the claim has been denied. For pre-service appeals please use the Grievance/Appeal Form located under Member Forms.
- Pharmacy Retail Prior Authorization Form (PDF)
- CoverMy Meds Link This is an external link that will take you outside the Oklahoma Complete Health website.
- MedPharm (JCODE) PA form (PDF) Coming Soon
- Telemedicine Guide (PDF) Coming Soon
- Weight Watchers Baseline Form (PDF) Coming Soon
- On-Site Interpreter Request Form (PDF)
Provider Contracting and Credentialing
- Contract Request Form (PDF)
- Hospital – Facility Provider Application Coming Soon
- Ownership and Controls Disclosure Form Coming Soon
- Practitioner Data Form Coming Soon
- PDM Credentialing Checklist (PDF)
- W9 Form
Provider Resources
- HEDIS Tip Sheets (PDF) - coming soon
- CAHPS® Information – ways to enhance relationships with patients and improve CAHPS® scores