Oklahoma
Medical Billing Services in Oklahoma
We take on billing and credentialing for practices across Oklahoma, at 4-8% of collections and with no long-term contract. SoonerCare, SoonerSelect, tribal health coordination, Medicare and commercial billing statewide.
Key takeaways
- 01SoonerCare must receive a claim within 6 months of the date of service, and within 90 days of the Medicare disposition where Medicare is primary (OAC 317:30-3-11).
- 02Since 1 April 2024, most SoonerCare members are in SoonerSelect, through Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma and Oklahoma Complete Health.
- 03Oklahoma requires insurers to pay or deny clean electronic claims within 30 days and paper claims within 45 days (36 O.S. 1219).
- 04The Indian Health Service is the payer of last resort, so Medicare, Medicaid and private insurance are billed first for tribal members.
How Practices in Oklahoma Rely on Medtransic
Oklahoma Payer Billing
One team for your SoonerCare, Medicare and private insurance claims
Coders Matched to Your Specialty
Your coder is matched to your specialty, whether that is therapy, psychiatry or another field
Dedicated Account Manager
A single point of contact who knows your Oklahoma practice
No Long-Term Contract
You pay 4-8% of collections, with no long-term contract to sign
Why Clinics in Oklahoma Count On Us For
SoonerCare Billing. Billing for SoonerCare and the three SoonerSelect managed care plans
HIPAA Compliant. Patient data handled under HIPAA, and one dedicated account manager as your contact
See How Much Revenue Your Oklahoma Practice Is Leaving on the Table
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Where We Work Across Oklahoma, City to City
Oklahoma City & Central Oklahoma
Oklahoma City is the state's largest healthcare market, anchored by OU Health (University of Oklahoma Health Sciences Center), INTEGRIS Health and Mercy. Energy employers provide employer-sponsored coverage, but energy price swings bring cycles of coverage loss that billing teams have to manage.
Blue Cross and Blue Shield of Oklahoma, part of HCSC, is one of the commercial payers Oklahoma City practices bill every day.
Cardiology / oncology / orthopedics / family medicine / behavioral health
Tulsa & Northeast Oklahoma
Tulsa's healthcare market is anchored by Saint Francis Health System, Ascension St. John and Hillcrest HealthCare System, serving Oklahoma's second-largest metro area. Aerospace, manufacturing and energy employers provide commercial coverage, and northeast Oklahoma's Native American population brings Indian Health Service and tribal health program billing.
Tribal nations headquartered in the area, including the Cherokee, Muscogee (Creek) and Osage nations, make tribal health program billing a routine part of Tulsa practice.
Cardiology / orthopedics / neurology / oncology / family medicine
Rural Oklahoma: Lawton, Enid & Regional Communities
Rural Oklahoma relies on critical access hospitals, rural health clinics and small practices serving farm and energy communities. Fort Sill near Lawton adds TRICARE claims, and long distances make telehealth important.
Since April 2024, most rural SoonerCare members are in SoonerSelect plans, each with its own authorization rules.
Family medicine / rural health / military medicine / general surgery / primary care
Frequent Questions on Billing Services in Oklahoma
Since 1 April 2024, most SoonerCare members are in SoonerSelect, through Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma and Oklahoma Complete Health. Each plan has its own authorization rules, fee schedule and claims process, and members outside SoonerSelect stay on SoonerCare fee-for-service.
Tribal members may receive care at tribal health clinics funded through IHS compacts or contracts, and referrals to non-tribal providers need Purchased/Referred Care authorization. Because the Indian Health Service is the payer of last resort, Medicare, Medicaid and private insurance are billed first.
36 O.S. 1219 requires insurers to pay or deny clean electronic claims within 30 days and paper claims within 45 days. Tribal health programs and self-funded employer plans are not governed by that state statute.
Federal law sets the baseline. Since January 2022 the No Surprises Act has kept providers from balance billing Oklahoma patients for most emergency care, and for out-of-network care delivered inside an in-network facility.
SoonerCare fee-for-service claims are due within 6 months of the date of service. Medicare allows 12 months from the date of service (42 CFR 424.44). SoonerSelect plans and commercial payers set their own limits in their contracts.
Complete Billing Support for Oklahoma Practices, End to End
From eligibility checks to final payment, we handle your billing so you can focus on patients.
Claims Management. Claim submission and follow-up until each claim is paid or closed
Denial Management. Denied claims worked and appealed
Patient Billing. Clear patient statements and payment plans
Credentialing. Payer enrollment at $150 per application, per provider, usually 60 to 90 days with each payer, in our experience
Want a Second Look at Your Billing?
Get a free, no-obligation review of your practice's billing.
- Where claims are being denied, and why
- Which unpaid claims can still be recovered
- What billing would cost at 4-8% of collections
Specialties We Support Across Oklahoma
Behavioral health and therapy lead the list for Oklahoma because that is the work we specialize in.
- Mental Health
- Psychiatry
- Speech Therapy
- Occupational Therapy
- Substance Use Treatment
- Psychology
- Behavioral Health
- ABA Therapy
- Physical Therapy
- Primary Care
- Internal Medicine
- Orthopedics
- OB/GYN
Get Started With Medtransic in Oklahoma and Stop Chasing Claims
Let us handle your medical billing so you can focus on patient care