SPOTLIGHT ITEM |
|
Has Your Information Changed? Update Us and the NPI Registry
Update the National Provider Identifier Registry and us when your practice address, phone number or other demographic information changes. Our members rely on accurate information to find care.
|
|
|
MEDICARE |
|
Medicare Providers May Treat Members of Blue Cross Group Medicare Advantage Open Access (PPO)SM
The only requirements are that you agree to see the member as a patient, accept Medicare and submit claims to the member’s Blue Cross and Blue Shield plan. Learn more about this national PPO plan.
|
|
|
NEWS & UPDATES |
|
Reminder: Statewide Fee Schedule Update
Included is information on how you can receive a copy of the current fee schedule.
|
|
|
|
Check Prior Authorization Requirements for Procedure Codes through Availity® Essentials or Our IVR System
Our IVR phone system has a new menu option to quickly confirm prior authorization requirements for procedure codes for our commercial members. Learn how Availity and our IVR system can help save you time.
|
|
|
|
Provider Finder® to Rank Providers to Help PPO Members Find Care
Later this year, Provider Finder will add a tiering feature that shows how providers rank against peers in their working specialties in some PPO products. Learn about the three tiers and how they help our members find care.
|
|
|
|
 |
CODING AND CLAIMS |
|
ClaimsXtenTM Quarterly Updates
New and revised Current Procedural Terminology and Healthcare Common Procedure Coding System 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 will normally load this additional data to the claim processing system after receipt from the software vendor and will confirm the effective date via the News and Updates section of the Provider website. Advance notification of updates to the ClaimsXten software version also will be posted on the Provider website.
To help determine how some coding combinations on a particular claim will be evaluated during the claim adjudication process, you can continue to use Clear Claim ConnectionTM. 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. 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 2023 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
CPT copyright 2023 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
|
|
|
|
|
|
|
 |
Provider Training
For dates, times and online registration, visit the Provider Training page.
|
|
|
 |
Online Provider Orientation
The Online Provider Orientation is a convenient and helpful way to learn about the online resources available to you.
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 medical policies at BCBSOK and their effective dates are posted on our 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.
Clinical Payment and Coding Policies
New or revised clinical payment and coding policies can be found on our 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.
|
|
|
 |
We Want Your Feedback
Do you have a helpful suggestion or feedback about our website? Fill out our Feedback Survey  .
|
|
|
|
|
|
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, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK.
|
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 2024 Health Care Service Corporation. All Rights Reserved.
Legal and Privacy | Unsubscribe
view in Web Browser
|
|
|
