CommunityCare is proudly owned by two of the region’s premier health systems. Other physicians and providers are available in our network.
Submit a message using our General Contact Information Form available online form by following this link. [opens in a new window]
Select Provider Contracting under What is this message regarding?.
A member of our Provider Network Administration Team will be in contact to obtain the necessary information to start the review process via a Participation Request Form.
Provider(s) must meet CommunityCare’s Participation Criteria which includes, but is not limited to:
Participation Request Forms must be fully completed and submitted with the requested W9 and sample claim form. Incomplete forms or missing documents will not be forwarded for review.
When all the necessary information has been received by the Network Administration Team your request is submitted for review by CommunityCare's Network Development Committee.
Provider Network Administration staff cannot extend a new contract without Executive level approval.
Provider Network Administration staff will communicate the determination received from the Committee .
If approved for participation, the Provider Network Administration staff will be your primary point of contact through the process until your contract has been assigned an effective date.
Contracts will be drafted and sent to you for signature.
Contracts cannot be assigned an effective date until:
You must have an effective contract and credentialing approval before rendering services to CommunityCare members.
Concurrent to the contracting process, the CommunityCare provider(s) credentialing process will begin.
CommunityCare’s Credentialing staff will obtain a credentialing application from CAQH.
If the provider does not utilize CAQH, then a credentialing packet will be emailed to the designated credentialing contact.
The Credentialing process does not get started until CommunityCare has a complete application which includes:
Once the provider(s) has/have been approved by the Credentials Committee and contracts have been signed and counter signed, your contract will be assigned an effective date by a Provider Network Administrator.
The 1st day of the month following Credentials Committee approval is the standard effective date.
The Provider Network Administrator will provide you with a copy of your fully executed and effectuated contract(s) and will connect you with your Provider Services Representative.
Your Provider Services Representative will be your primary contact going forward during your participation with CommunityCare.
What information should be updated?
Contact your designated Provider Services Representative to make the changes noted above.
Check Your Directory InformationUpdated certificates of malpractice insurance or loss of license(s) to practice should be reported to CommunityCare’s Credentialing Team within 10 days of the update or change.
CommunityCare accepts 837 EDI claim submissions via Availity.
To enroll for EFT Payments, complete and submit the CommunityCare EFT Enrollment form [opens in a new window] . (Enrollment form instructions [opens in a new window].)
To enroll for 835/ERA delivery you will need to complete and submit the CommunityCare 835/ERA Enrollment form [opens in a new window] and you must enroll with Availity if you are not already enrolled. (Enrollment form instructions [opens in a new window].)
Contact Availity Client Services 800-282-4548 (800-AVAILITY) to speak with an Availity Client Services representative for questions regarding the Availity enrollment process.
If you think you may have missing backlogged ERAs from the Change Healthcare disruption earlier in 2024, you must open a ticket with Availity Client Services:
CommunityCare offers 270/271 Eligibility Benefit Inquiry (Real-Time Eligibility).
*Please work with your clearinghouse if you are not able to send a request and/or receive a response for these transactions.
CommunityCare offers 276/277 Claim Status Request and Response transactions.
*Please work with your clearinghouse if you are not able to send a request and/or receive a response for these transactions.
Member eligibility, benefits and claim status can also be viewed via CommunityCare’s provider portal, CareWeb. Submit a CareWeb Security Request form [opens in a new window] to request access to CareWeb.
Hospitals - Health Systems - Network(s)
Ascension St. John (VM)
OSU Medical Center (OS)
CommunityCare (CI) (Metro Tulsa)
Metro Tulsa Behavioral Health (excluding Laureate)
Saint Francis (PM)
Laureate (B4)
Tulsa area Chiropractors
Muskogee (MR)
Vinita (VI)
Bristow (BR), Grove (GR), McAlester/Pittsburg (MP)
Okmulgee (OK), Drumright (SA), Stillwater (SC)
Tahlequah (TA), Wagoner (WG)
Rural area Behavioral Health and Chiropractors
Vision Providers in all areas
Hillcrest (HT)
St. Anthony (HS), Integris (IN), Mercy (MY),
Norman (NM), OU Medicine (UN)
OKC area Behavioral Health and Chiropractors
Freeman PHO
Rural Southern & Western OK
CareWeb, EFT & 835/ERA Liaison
Ancillary Service Providers:
Durable Medical Equipment
Orthotics & Prosthetics
Skilled Nursing Facilities
Long Term Acute Care Hospitals
Ambulatory Surgery Centers
Freestanding Radiology and Physical/Occupational/Speech Therapy