| |
News & Updates |
|
BlueApprovRSM Now Accepts Online Recommended Clinical Reviews (Formerly Predeterminations) — Attend a Training
These instructor-led, free webinars help you learn how to use BlueApprovR. |
|
|
|
Survey Assesses Medicare Advantage Members’ Health Outcomes
Please encourage members to respond to these surveys, which helps identify ways to improve health care plans. |
|
|
|
Update Your Records: New Mailing Address for Paper Commercial Claims and Inquiries
The new address is effective immediately. |
|
|
|
Supporting Quality Care During Breast Cancer Awareness Month
Remind your patients how routine screenings can help improve their outcome with breast cancer. |
|
|
|
Avalon Healthcare Solutions - Trial Claim Advice User Guide
Here is a step-by-step breakdown on how to use this guide. |
|
|
|
Helpful Tips: Avalon - Lab Management Program for BCBSOK Members
This is a valuable resource when utilizing Avalon Healthcare Solutions program for particular outpatient laboratory services. |
|
|
|
Current Procedural Terminology® (CPT®) Codes Updated for Prior Authorization for Medicare, Oct. 1
Requirements are changing for a couple of lab codes involving eviCore. |
|
|
|
Reminder for Billing Point-Of-Use Convenience Kits
Don't forget that only the drug component of point-of-use convenience kits is reimbursable to the provider. |
|
|
|
Select Medication List to be Discontinued
The list included specific medications eligible for increased reimbursement over similar medications within the same drug class. |
|
|
|
ClaimsXten™ Quarterly Update Effective Dec. 4, 2023
These fourth quarter updates will include changes to Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes. |
|
|
|
Updates to Clinical Practice and Preventive Care Guidelines
The guidelines draw from evidence-based standards of care and nationally recognized medical authorities. |
|
|
|
What Do BCBSOK Members Want from their Health Care Professionals? Part 2
In part 2 of our member survey, we talk about building rapport, listening closely for feedback and being conscious of potential barriers. |
|
|
|
BCBSOK will begin Provisional Credentialing Effective Nov. 1, 2023
With certain exceptions, all contracted providers must be credentialed with BCBSOK. |
|
|
|
| |
Provider Data and Directory Updates |
|
Your directory information must be verified every 90 days under a new federal law, even if your data hasn’t changed. Verification of information includes provider name, organization name, specialty, address, phone and digital contact information.
It’s easy and quick to get it done for all health plans using the Availity® Essentials Provider Data Management feature. If you’re unable to use Availity, you may use our Demographic Change Form . Facility and Ancillary providers may only use the Demographic Change Form to verify and update information. If we haven’t received your verification, look for emails from us with the checkmark symbol. They’re a friendly reminder that it’s time to verify. Learn more about verifying your data. |
|
Web Changes |
|
|
ClaimsXten™ Quarterly Updates |
|
New and revised Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are periodically added to, or deleted from, the ClaimsXten code auditing tool software by the software vendor on a quarterly basis and are not considered changes to the software version. Blue Cross and Blue Shield of Oklahoma (BCBSOK) will normally load this additional data to the BCBSOK claim processing system after receipt from the software vendor and will confirm the effective date via the News and Updates section of the BCBSOK Provider website. Advance notification of updates to the ClaimsXten software version also will be posted on the BCBSOK Provider website.
To help determine how some coding combinations on a particular claim to be evaluated during the claim adjudication process, you can continue to use Clear Claim ConnectionTM (C3). C3 is a free, online reference tool. Refer to the Clear Claim Connection page on our website for more information on gaining access to C3, as well as answers to frequently asked questions about ClaimsXten. Updates to be included in future issues of the Blue Review. Note: C3 does not contain all of the claim edits and processes used by BCBSOK in adjudicating claims, and the results from use of the C3 tool are not a guarantee of the final claim determination.
ClaimsXten and Clear Claim Connection are trademarks of McKesson Information Solutions, Inc., an independent company providing coding software to BCBSOK. McKesson Information Solutions, Inc. is solely responsible for the software and all the contents. Contact the vendor directly with any questions about the products, software and services they provide.
CPT copyright 2018 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA. |
BCBSOK Online Provider Orientation |
|
The Online Provider Orientation is a convenient and helpful way to learn about the online resources available to you. |
Clinical Payment and Coding Policies Reminder |
|
New or revised BCBSOK clinical payment and coding policies (CPCPs) can be found on the BCBSOK website. These policies provide billing, coding, and documentation guidelines that you may find useful in your practice or facility. Please visit this site regularly to ensure you are up to date on any changes or new policies. These policies can be accessed on the Clinical Payment and Coding Policies page of our website. |
On-demand Training |
|
An eRM tutorial is available to show you how to navigate the features of the eRM tool. Log in at your convenience to complete the tutorial and use it as a reference when needed. |
Medical Policy Reminder |
|
Approved new or revised BCBSOK medical policies and their effective dates are posted on the BCBSOK website the first and fifteenth day of each month. These policies impact your reimbursement and your patients’ benefits. You can view all active and pending policies or view draft Medical Policies and provide comments. These can be accessed on the Standards and Requirements page of our website.
While some information on new or revised medical policies occasionally be published for your convenience, please visit bcbsok.com/provider for access to the most complete and up-to-date information. |
We Want Your Feedback |
|
Do you have a helpful suggestion or feedback about our website? Fill out our Feedback Survey. |
|
|
|
 |
|
|
|
 |
Provider Training
For dates, times and online registration, visit the Provider Training page.
|
|
|
|
|
|
 File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. You can download other tools and learn more about accessibility at adobe.com  .
By clicking this link, you will go to a website/app (“site”). The site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. Some sites may require you to agree to their terms of use and privacy policy.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.
|
Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
|
1400 S. Boston, Tulsa, OK 74119
© Copyright 2023 Health Care Service Corporation. All Rights Reserved.
Legal and Privacy | Unsubscribe
view in Web Browser
|
|
|
| |
