OK Medicaid

Claim Procedures for Oklahoma Medicaid

For a comprehensive list of common codes and their descriptions specific to Oklahoma Medicaid electronic claims, visit the following link: Oklahoma Medicaid NCPDP Claim Tools.

Common Issues for Oklahoma Medicaid

Issue: The claim received a crosswalk error and did not process accordingly. 

Reason: It is possible that code G was not included in the claim. The provider is a contracted provider as a group with OK Medicaid. Therefore, a G is required in the 2300 loop (NTE*ADD*OKCODEG) This is per the SoonerCare Specific Requirements. 

Medicaid Crosswalk

Per HIPAA 5010 X12 standards, Medicaid is not allowed to receive a Medicaid provider ID on electronic claims, if the provider has an NPI.

This payer uses a table of information or "crosswalk" to associate the payer assigned provider IDs to each claim. Verify the information sent in these fields matches the provider ID record in the payers system:

• Provider NPI
• Provider Address
• Provider taxonomy code