Medicaid

How to Get Credentialed with SoonerCare in Oklahoma

Network: Open
30-60 Days

Quick Overview

Timeline

30 - 60 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Oklahoma-Specific Requirements

Oklahoma Medicaid (SoonerSelect) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the OHCA (Oklahoma Health Care Authority) provider enrollment portal. (3) Submit application with OK state license, proof of malpractice insurance, and required documentation. (4) Background check including OSBI and federal criminal history is required for all providers. Oklahoma transitioned to managed care in 2024 through SoonerSelect with 2 MCOs covering most Medicaid beneficiaries. Behavioral health providers accepted include LPC, LCSW, and LMFT with active Oklahoma licensure. Revalidation is required every 5 years.

Medicaid Information: Oklahoma

Agency: Oklahoma Health Care Authority

Program: SoonerCare

Portal: https://www.okhca.org/providers

Phone: 1-800-522-0114

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Oklahoma.

2

Prepare Your Application

Complete SoonerCare's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to SoonerCare.

4

Track & Follow Up

Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

Need help enrolling with SoonerCare?

Our specialists handle the entire SoonerCare enrollment process: applications, follow-ups, and approvals in Oklahoma.

Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

Oklahoma Medicaid Provider Enrollment (SoonerCare)

Required
Online Open →

Key Credentialing Terms

Capitation
A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Managed Care
A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
Network Adequacy
The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to SoonerCare.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-800-522-0114

Mon-Fri 8am-5pm

Provider Services

National

1-800-522-0114

Claims & Billing

National

1-800-522-0114

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Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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