Okla. Stat. tit. 74, § 74-1328

This is the official text of Okla. Stat. tit. 74, § 74-1328, part of Oklahoma’s Stat. tit. 74, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 74,." Browse the sections below, each linked to its official government source.

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Reimbursement of claims within certain time period

Official statutory text

A. The contracted claims administrator for the Oklahoma Health

Care Authority shall reimburse all clean claims of an enrollee, an

assignee of the enrollee, or a health care provider within forty-

five (45) calendar days after receipt of the claim by the entity.

B. As used in this section, "clean claim" means a claim that

has no defect or impropriety, including a lack of any required

substantiating documentation, or particular circumstance requiring

special treatment that impedes prompt payment.

C. 1. If a claim or any portion of a claim is determined to

have defects or improprieties, including a lack of any required

substantiating documentation, or a particular circumstance requiring

special treatment, the enrollee, assignee of the enrollee, or health

care provider shall be notified in writing within thirty (30)

calendar days after receipt of the claim by the contracted claims

administrator for the Authority. The written notice shall specify

the portion of the claim that is causing a delay in processing and

explain any additional information or corrections needed. Failure

of the Authority's claims administrator to provide the enrollee,

assignee of the enrollee, or health care provider with such notice

shall constitute prima facie evidence that the claim will be paid in

accordance with the terms of the health benefit claims

administration contract.

2. The portion of the claim that is accurate shall be paid

within forty-five (45) calendar days after receipt of the claim by

the claims administrator for the Authority.

D. Upon receipt of the additional information or corrections

which led to the claim's being delayed and a determination that the

Oklahoma Statutes - Title 74. State Government Page 829

information is accurate, the claims administrator for the Authority

shall either pay or deny the claim or a portion of the claim within

forty-five (45) calendar days.

E. Payment shall be considered made on:

1. The date a draft or other valid instrument which is

equivalent to the amount of the payment is placed in the United

States mail in a properly addressed, postpaid envelope; or

2. If not so posted, the date of delivery.

F. An overdue payment shall bear simple interest at the rate of

ten percent (10%) per year.

G. In the event litigation should ensue based upon such a

claim, the prevailing party shall be entitled to recover a

reasonable attorney fee to be set by the court and taxed as costs

against the party or parties who do not prevail.

Status: in_force · Read it on the official government site

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About this page: Statute text is reproduced from official government publishers via the Open US Law dataset (Vaquill AI, snapshot v2026.08, CC BY 4.0). Primary legislative text like this is public domain under the government-edicts doctrine (Georgia v. Public.Resource.Org, 2020). We link every section back to its official source so you can verify it independently.