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OHCA Referrals on SoonerCare Cases

The way CSS receives referrals from OHCA (SoonerCare) has been changed and because of the change, new OHCA case referrals are down significantly.

Impact of OHCA referral changes:

  • To comply with provisions of the Affordable Care Act and mandates from the Federal CMS office, OHCA took the final steps to remove Absent Parent data from their SoonerCare application for benefits. These changes were implemented by OHCA December 2, 2016.
  • Since the referrals no longer include Absent Parent info they are no longer adequate referrals to initiate a child support case. All inadequate referrals are quarantined and do not come to RFLI (case initiation) screens. The data is in OSIS, but would not include AP data.

Plan A, B & C to recover some or all OHCA referrals:

  • Plan A was to work with OHCA within their federal requirements to link SoonerCare applications to a new online child support Application. OHCA initially agreed to work with CSS, including using special 90% funding available to OHCA for Interoperability. In the end, OHCA rejected the concept. Plan A.2 may allow CSS to still have an online CSS Application using the OKDHS.Live software tools. There is no start date for this option at this time.
  • Plan B – CBPE has developed an improved automated cross-referencing process that has already started. While we no longer have an AP, the new auto-cross-referencing uses both the children and CP demographic data to locate open and closed child support cases. Open cases are automatically cross-referenced with no CSS staff action (keeping case types & other links correct.) When Closed CSS cases are matched, a new RFLI is created and that “CSE” REFLI is reviewed to determine if the child support case should be reopened. Further evaluation of this new methodology may lead to more cross-referencing to SoonerCare cases that started before 12/2/2016.
  • PLAN C – CSS is going to reach out to future SoonerCare Applicants and asked if they want a child support case. It will not recover all (and maybe not that many), but the people that do want our services will be able to easily start a new case.

    This process will start with a predictive dialing call to the OHCA Applicant. We are also researching the ability to send emails to these OHCA online applicants. The message will be that CSS can help them with a child support case – call Child Support at 1-800-522-2922. These calls will be routed from CARE to CIC staff. AS CIC staff talk to the customer they will gather the AP information that would be necessary to complete an adequate OHCA referral.

    The info will be input during the call on a new AP info screen. When completed, the AP info will be linked to the OHCA partial referral and will create a new RFLI for the customer.

    This project is in development now. The customer calls and new CIC screen are projected to be ready by approximately 4/1/2017. Until then CARE staff request customers to complete an application.