Oklahoma Complete Health providers must keep accurate and complete medical records. Such records will enable providers to render the highest quality healthcare service to enrollees. They will also enable Oklahoma Complete Health to review the quality and appropriateness of the services rendered. Oklahoma Complete Health will conduct random medical record audits as part of its QI program to monitor compliance with the medical record documentation standards. For more detailed information about standards, please see the MRR section of the Oklahoma Complete Health Provider Manual.
The coordination of care and services provided to enrollees, including over/under utilization of specialists, as well as the outcome of such services also may be assessed during a medical record audit. Oklahoma Complete Health will provide written notice prior to conducting a medical record review.