Welcome to the Oklahoma Corrections (DOC) Provider Network. Click here for more information about Oklahoma Corrections.

DOC Network Providers

Welcome to Oklahoma Corrections (DOC) Provider Network. This site will allow you to search our provider network database, read related news and download network provider contracts. Questions and comments can be addressed here. Click HERE for more information about Oklahoma Corrections.

DOC Billing Update

Billing for DOC inmates

To be reimbursed for medical or dental services provided to DOC inmates, you must bill the Department of Corrections within 120 days of providing services and adhere to following the directions below.

You may file claims electronically with payer ID 71065, through the provider portal (you can upload a claim with PCH or you can manually key a claim with iEDI), or mail paper claims to DOC Claims, P.O. Box 30522, Salt Lake City, UT 84130-0522.

  • Bill with group number 76415170.
  • Add the prefix 365000 to the DOC inmate ID number if it is 6 digits.
  • Add the prefix 36500 to the DOC inmate ID number if it is 7 digits.
  • Enter the updated prefix+ digit DOC inmate ID number when making a DOC inquiry using the IVR system or provider portal

The updated DOC inmate ID number, after adding the prefix, should always be 12 digits. To verify the DOC inmate ID number, visit https://okoffender.doc.ok.gov/.

You cannot invoice or balance bill the inmate for reimbursement. Invoices received by DOC or the inmate will be disregarded. DOC claims are paid at 100% of the fee schedule allowable. You can view allowable amounts for DOC claims by logging into the DOC Fee Schedule.

For questions, call the Customer Care team at toll-free 800-323-3710. TTY users call 711.

5024

Provider Customer Service

Provider Customer Service

Customer Care is available for all eligibility, benefits, claims, coverage, certification and appeals. Portions of this information can be viewed on the HealthChoice Provider Portal, or you can contact Customer Care at toll-free 800-323-4314. TTY users 711.

EGID Network Management is available for assistance for providers participating in the HealthChoice, DOC and DRS networks. Contact EGID Network Management for questions pertaining to contracting, updating network provider demographics, provider directory updates, fee schedules and fee schedule access.

Demographic information can be viewed and updated on the provider contracting portal. Additional information can be found in the Policies and Guidelines section of the provider website. If you contact Customer Care and are unable to get a resolution, ask for a call reference number and then email EGID Network Management.

Office hours for EGID Network Management are 8:00 a.m-4:30 p.m., Monday through Friday, excluding state holidays. Email inquiries, or call toll-free 800-323-3710. TTY users 711.

Department of Corrections - Network Providers

Posted 01/16/2020

The Department of Corrections plan is a managed health care program that provides comprehensive health and dental benefits to approximately 22,000 inmates sentenced to incarceration with the Oklahoma DOC.

The DOC plan is a partnership between the Oklahoma DOC, providers and the OMES Employees Group Insurance Division in the delivery of health care services and products that help control costs and assist in the provision of high-quality health care. Your help as a health care professional is needed to achieve this goal.

Entry into the DOC network is pre-approval for treatment.

The DOC will work with you to schedule a time that works for your office. A correctional officer will accompany all inmates at all times. If needed, the correctional officer will bring the inmate through an alternative entrance. The DOC will work with your staff to schedule appointments before or after regular patient hours, utilizing as much discretion as necessary to not interfere with other patient care.

Network DOC providers utilize the same allowable fees as HealthChoice network providers. The DOC fee schedule is available at https://gateway.sib.ok.gov/DOC/FeeSchedule/Login.aspx. Providers that are not part of the DOC network are paid per the Medicaid fee schedule.

Network providers are contractually obligated to provide health care services to inmates upon scheduling requests by the DOC.

For more information, call toll-free at 800-323-3710 or email EGID.DOCNetworkManagment@omes.ok.gov. A network management specialist will be happy to assist you.

Top

Become a Department of Rehabilitation Services Provider

Posted 10/25/2017

Did you know that the Employees Group Insurance Division also maintains the Oklahoma Department of Rehabilitation Services Provider Network? DRS expands opportunities for employment, independent life and economic self-sufficiency by helping Oklahomans with disabilities bridge barriers to success in the workplace, school and home. DRS operates dozens of programs that help Oklahomans lead more independent and productive lives by aiding with:

  • Assistive technology.
  • Education.
  • Employment services.
  • Health and mental health services.
  • Housing assistance.
  • Personal assistance and in-home services.
  • Transportation.

The goal of DRS is to provide rehabilitation and the opportunity for independent living for disabled Oklahomans. Your help as a health professional is needed to achieve this goal. We encourage you to reach out and become a DRS network provider.

For more information, please visit our network provider home page at gateway.sib.ok.gov/DRS, email network management at EGID.DRSNetworkManagement@omes.ok.gov, or call us.

Top

Top

Other Information

Inmates will always be accompanied by a Department of Corrections employee.  If you have any questions concerning eligibility, please contact Debbie Elledge.

Case Management

If you have any questions concerning case management or discharge planning for inmate patients, please contact Jane Kirby.

Top

Top