Credentialing in Oklahoma
Soft Home Global provides payer enrollment, revalidation and follow-up for Oklahoma practices and billing companies at $2,100 per seat per month. Full time, worked during Oklahoma business hours, inside your own system.
What is specific to Oklahoma
SoonerCare is administered by the Oklahoma Health Care Authority, which ran a largely fee-for-service model before moving a large share of members into SoonerSelect managed care plans.
Oklahoma’s Medicaid programme is SoonerCare. Practices with a meaningful SoonerCare mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a credentialing seat does in Oklahoma
Applications, revalidations and payer follow-up, with every enrollment's status visible.
SoonerCare is not one enrollment but one per plan, and every one of them has a revalidation date that stops payment when it passes. That calendar is the work.
- Initial applications prepared and submitted
- Revalidations tracked ahead of the deadline
- CAQH kept current
- Payer follow-up until an effective date is issued
- Status of every enrollment visible to you
- Worked during Oklahoma business hours, not queued overnight
For the statute behind all of this — Oklahoma’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Oklahoma billing page.
SoonerCare, in practice
SoonerCare shifted most members into managed care on April 1, 2024 under SoonerSelect, with three statewide medical plans covering non-disabled children (including foster care), low-income parents, pregnant women and non-disabled adults 19-64. Quote: "Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma and Oklahoma Complete Health." Source
Working Oklahoma hours
Oklahoma runs on Central time, 11 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 8pm to 4am, and 7pm to 3am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Oklahoma hours and nobody else’s.
What it costs in Oklahoma
$2,100
Per seat, per month, in US dollars — $25,200 a year for one full-time person, forty hours a week, on Oklahoma hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Oklahoma run $1,450 to $2,400; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Oklahoma
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with Oklahoma practices?
Yes. Oklahoma accounts are worked during Oklahoma office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Oklahoma?
SoonerCare is administered by the Oklahoma Health Care Authority, which ran a largely fee-for-service model before moving a large share of members into SoonerSelect managed care plans.
How long do we have to file a SoonerCare claim?
6 months from the date of service, measured from the date of service. A denied claim can be considered proof of timely filing. Past that date a claim is not late, it is unpayable, and no appeal recovers it. Source: OAC 317:30-3-11 — Timely filing limitation.
When does a Oklahoma payer have to pay a clean claim?
30 calendar days for electronic clean claims; 45 calendar days for paper clean claims A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does credentialing cost in Oklahoma?
$2,100 per seat per month — $25,200 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Oklahoma queue?
Oklahoma is on Central time, 11 hours behind Rawalpindi. The shift here runs 8pm to 4am so your seat is at a desk for your full working day, shifting to 7pm to 3am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle SoonerCare as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. SoonerCare has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Oklahoma work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com