Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 33 - TRANSPORTATION BY AMBULANCE
Section 317:30-5-336 - General coverage
Current through Vol. 42, No. 1, September 16, 2024
(a) OHCA covers ground and air ambulance transportation services, within certain limitations.
(b) OHCA recognizes different levels of ambulance medical services by qualified ambulance staff according to the standards established by law and regulation through the Oklahoma Emergency Response System Development Act of 2005, '63 OS 1-2503.
(c) Ambulance medical services are divided into different levels for payment purposes. Payment is made according to the medically necessary services actually furnished. That is, payment is based on the level of service furnished, not simply on the vehicle used.
(d) Ambulance providers must maintain documentation of the medical necessity and appropriateness of service in the member's file.
(e) Clinical decisions can be made without delay if documentation to support coverage and medical necessity is submitted as part of the initial claim form. This may be accomplished by submitting supporting detailed documentation regarding the member's condition and need for ambulance/stretcher transport.
Added at 12 Ok Reg 751, eff 1-5-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3131, eff 7-27-95; Amended at 23 Ok Reg 265, eff 10-3-05 (emergency); Added at 23 Ok Reg 1360, eff 5-25-06; Amended at 24 Ok Reg 601, eff 12-21-06 (emergency); Amended at 24 Ok Reg 920, eff 5-11-07
