Medical Billing Services in Oklahoma

Oklahoma’s Medicaid program changed fundamentally in 2024, and practices still adjusting to the new model feel it in their denials. Most SoonerCare members moved from fee-for-service into managed care under SoonerSelect, which means paneling, authorization, and claim routing now run through three contracted plans instead of the state directly. A practice that still bills the way it did before the transition, or that is not paneled with the patient’s specific plan, will see claims stall before they are ever adjudicated.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for Oklahoma practices of every specialty, built around the state’s actual payers and programs.

Oklahoma’s payer landscape

SoonerCare, administered by the Oklahoma Health Care Authority, is the state’s Medicaid program. Since April 1, 2024, most SoonerCare members receive their benefits through SoonerSelect, the state’s managed care program. Three contracted plans serve SoonerSelect members: Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma, and Oklahoma Complete Health. Members choose a plan or are auto-assigned, and each plan builds its own provider network across all 77 counties. Because the model is still relatively new, confirming which SoonerSelect plan covers a patient, and that the provider is paneled with it, is the front-end step that keeps a claim from denying.
Commercial coverage is led by Blue Cross Blue Shield of Oklahoma, alongside CommunityCare, GlobalHealth, Aetna, and UnitedHealthcare. Medicare Part B is administered by Novitas Solutions under Jurisdiction JH. Oklahoma’s tribal health system adds another coverage path for Native patients, which has to be identified at intake rather than discovered at denial.

What MedPlus RCM handles for Oklahoma practices

  • End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing. The full cycle.
  • Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
  • Provider credentialing and enrollment. End-to-end enrollment with SoonerSelect plans, commercial payers, and Medicare, plus re-credentialing maintenance.
  • Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
  • A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
  • Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
    We serve practices statewide, Oklahoma City, Tulsa, Norman, Broken Arrow, and Edmond, across specialties including primary care, mental and behavioral health, physical therapy, dermatology, cardiology, and orthopedics.

Results Oklahoma practices can check

MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.

Frequently asked questions

What changed when SoonerSelect launched?
On April 1, 2024, most SoonerCare members moved from fee-for-service into managed care. Benefits now run through three plans, Aetna Better Health of Oklahoma, Humana Healthy Horizons, and Oklahoma Complete Health, each with its own network and authorization rules. Paneling with the patient’s specific plan is now required for payment.
Do you work with all three SoonerSelect plans?
Yes. We bill Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma, and Oklahoma Complete Health, as well as commercial and Medicare plans.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.

Get a free financial audit

Find out where your Oklahoma practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
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