How to become a Medicaid provider in Oklahoma
To bill Oklahoma Medicaid, enroll through OHCA Provider Portal (ohcaprovider.com) — online provider contracting. The process has 5 steps, listed below with the documents the state asks for.
- Enrollment portal
- OHCA Provider Portal (ohcaprovider.com) — online provider contracting
- Steps
- 5
- Documents
- 6
- Plans listed
- 5
On this page
Oklahoma Medicaid enrollment at a glance
To bill Oklahoma Medicaid, enroll through OHCA Provider Portal (ohcaprovider.com) — online provider contracting. The process has 5 steps, listed below with the documents the state asks for.
- Program
- SoonerCare (Oklahoma Health Care Authority, OHCA), including SoonerSelect managed care
- Application fee
- OAC 317:30-3-19.4 sets the fee at the CMS amount, adjusted for inflation, for provider types listed in OHCA's appendix. Individual physicians and non-physician practitioners are exempt, as are providers who already paid the fee to Medicare or another state's Medicaid/CHIP program. The fee is not refunded if screening leads to denial. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.
- Fingerprinting
- Under OAC 317:30-3-19.4, high-risk screening adds a fingerprint-based criminal background check of the provider and of anyone owning 5% or more. OHCA's enrollment sheet lists DME and home health as high-risk provider types and says providers enrolled with Medicare may be exempt. Limited- or moderate-risk providers move to high risk after a fraud-based payment suspension, an overpayment, or an exclusion.
- Site visit
- Moderate-risk screening includes pre- and post-enrollment site visits by OHCA Provider Enrollment staff. OHCA lists these moderate-risk types: ambulance services, behavioral health agencies and groups, individual behavioral health providers, hospice, independent diagnostic testing facilities, laboratories, and physical therapy groups and physical therapists. High-risk types also get site visits.
- Revalidation
- OHCA screens and enrolls providers and revalidates them periodically, as federal rules require. Existing providers handle this through 'renewal contracts' in the OHCA provider portal. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.
- Provider manual
- Provider manual
Steps
- Get an NPI and create a user in the OHCA provider portal ('New contracts')
- Fill out the online SoonerCare provider contract for your contract type, with ownership disclosures and forms such as EFT and Group Appendix A
- Pay the application fee if your provider type owes it, then complete risk-based screening (site visit or fingerprints if applicable)
- Track the application with 'Check Application Status'
- For SoonerSelect, apply for credentialing through Availity, the single repository all plans use (this can run alongside OHCA enrollment), then contract with each plan
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Centralized credentialing: partly. OHCA enrollment is separate from credentialing. OHCA requires all three SoonerSelect contracted entities to use one credentialing repository (Availity) and one credentialing verification organization for SoonerSelect-only providers, so a provider submits its information once. Each plan still decides on credentialing, within 45 days of a complete application (plus 15 with an OHCA-approved extension), and contracts separately. Credentialing cannot finish until the provider has an OHCA Medicaid ID and appears on the provider master list.
- Plans (state list)
- Aetna Better Health of Oklahoma
- Humana (SoonerSelect health plan)
- Oklahoma Complete Health
- DentaQuest (SoonerSelect Dental)
- LIBERTY Dental Plan of Oklahoma (SoonerSelect Dental)
Frequently asked questions
How do I become a Medicaid provider in Oklahoma?
To bill Oklahoma Medicaid, enroll through OHCA Provider Portal (ohcaprovider.com) — online provider contracting. The process has 5 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Oklahoma Medicaid?
OAC 317:30-3-19.4 sets the fee at the CMS amount, adjusted for inflation, for provider types listed in OHCA's appendix. Individual physicians and non-physician practitioners are exempt, as are providers who already paid the fee to Medicare or another state's Medicaid/CHIP program. The fee is not refunded if screening leads to denial. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.
How often must Oklahoma Medicaid providers revalidate?
OHCA screens and enrolls providers and revalidates them periodically, as federal rules require. Existing providers handle this through 'renewal contracts' in the OHCA provider portal. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.