Oklahoma Uniform Credentialing Applications (OUCA) will not be considered complete unless accompanied by an OUCA Supplement and the required attachments.
Completed OUCA and DOC facility applications can be signed, scanned in, and then emailed. If this is not an option for you, mail or fax it to:
Please direct all email submissions to your designated contracting representative. If you are not aware of your representative direct them to: EGID.DOCNetworkMangement@omes.ok.gov .
(An OUCA application and supplement must be completed and submitted with the signature page from the most appropriate contract)
First Amendment of Oklahoma DOC Network Facility Contract
*Radiology, Sleep Study Providers and Independent Diagnostic Testing Facilities must complete and sign the First Amendment of the DOC Network Facility Contract. The amendment must accompany a completed Network Facility Application and signed signature page when it is submitted to DOC Network Management to complete the application process. If the amendment is not received as an attachment to the application, it will be considered incomplete which will delay your effective date as a Network Provider.
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Built and maintained by the Office of Management and Enterprise Services Employees Group Insurance Division.