Oklahoma Payment Resources
Summary of payment program
Billing
Pursuant to 22 O.S. § 40.1, the victim of the crime of rape or forcible sodomy has the right to a free forensic medical examination. Pursuant to 21 O.S. §142.19 & 142.20, the Sexual Assault Examination Fund is established for the purpose of providing the victim of a rape, rape by instrumentation, or forcible sodomy a forensic medical examination.
Payment
The Crime Victims Compensation Board has established the procedures for disbursement of the Sexual Assault Examination Fund. Pursuant to statute, no more than Four Hundred Fifty Dollars ($450.00) can be paid from the Sexual Assault Examination Fund for a sexual assault forensic medical examination; and no more than Fifty Dollars ($50.00) can be paid for medications which are related to the sexual assault, and directed and deemed necessary by the health care professional. Such payments may not exceed the amounts specified by law, regardless of the amount of any individual bills comprising the claim. Payments up to the statutory maximum may be made directly to the service provider(s) for the sexual assault forensic medical examination.
Payments are generally made within three weeks of approval. Payments are sent directly to service providers on outstanding balances at a rate of 80%. Medical, dental, and counseling service providers are required by law to write off the remaining 20% if they accept payment from the Crime Victims Compensation Board. Medical, dental, and counseling expenses that the victim is out-of-pocket will be reimbursed at 100%, provided there is documentation of payment and no collateral sources exist.
Application for Payment of Sexual Assault Forensic Medical Examination | PDF
After the victim of a sexual assault has received a forensic medial examination, the following steps must be taken to request payment for the exam:
- The hospital emergency room should have the victim or victim’s parent/guardian complete ALL of the Victim Verification section.
- The hospital should complete the Medical Facility Information section.
- The medical professional conducting the exam should complete the Examining Physician or SANE Nurse Verification section completely.
- Attach an itemized statement for each provider seeking payment to the back of the application. Tax ID and Social Security Numbers must be listed for anyone receiving a payment.
- Forward the application and attached itemized statements to the District Attorneys Council, Victims Services Division, 421 N.W. 13th Street, Suite 290, Oklahoma City, OK 73103.
- Do not mail application in Red Envelope.
- Do not place application in completed rape kits.
- Do not send application with patient.
Oklahoma Crime Victims’ Compensation Program Information
Oklahoma Crime Victims’ Compensation Instructions and Application | Spanish
OK Crime Victims’ Compensation Eligibility:
- Crime must be reported to law enforcement officials within 72 hours of the incident (may be waived for good cause).
- File this claim within one year of incident or death of victim (deadline may be waived in certain cases and for good cause).
- Victim was not the offender or accomplice and compensation would not benefit the offender or accomplice.
- There is economic loss after collateral resources have been deducted.
- Victim and claimant cooperated fully with the appropriate law enforcement agencies.
- The victim did not contribute in any way to the injury or death upon which the claim is based.
After all sections of the claim form are completed and is signed, mail, fax, or email the claim form to:
Official Claim Form
421 N.W. 13TH Street, Suite 290
Oklahoma City, OK 73103
Phone: 405/264-5006 or 800/745-6098
Fax: 405/264-5097
Email: victimsservices@dac.state.ok.us
Coordination with healthcare
Sexual assault is defined as any sexual activity involving a person who does not or cannot (due to alcohol, drugs, or incapacitation) consent. Patients 18 years of age and older, have the option of whether or not to report the assault to law enforcement. Regardless of whether they report the assault, all victims have the right to a medical forensic examination, crisis intervention, counseling, support groups and medical care.
A sexual assault nurse examiner can evaluate an adult or adolescent victim whose assault has occurred within the previous 120 hours (5 days).
Oklahoma Coalition Against Domestic Violence and Sexual Assault
Oklahoma Hotline: 800-522-SAFE (7233)
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Oklahoma Sexual Assault Evidence Collection & Kit Tracking System