Blue Review – Oklahoma Division

BlueCross BlueShield of Oklahoma
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Blue Review

For Providers

February 2024


News & Updates

Blue Cross and Blue Shield Federal Employee Program® HEDIS® Records: Collecting February through April 2024

The data we collect for HEDIS measures are developed by the NCQA.

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Managing Antidepressant Medication

We encourage you to talk to our members about getting help for depression.

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Supporting Healthy Hearts

Please use this information to talk to our members about ways to reduce and manage their risks for heart disease and stroke.

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ClaimsXten™ Quarterly Update Effective April 15, 2024

These first quarter updates may include Current Procedural Terminology and Healthcare Common Procedure Coding system codes.

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Pharmacy Program Quarterly Update: Changes Effective Jan. 1, 2024 – Part 2

These are the remainder of the first quarter updates for 2024.

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Coding Webinars: Major Depressive Disorder and Annual Wellness Visits

These free webinar topics include ICD-10 CM guidelines, CMS Version 28 risk adjustment and closing gaps in care for patients.

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Changes to Claim Inquiry Resolution – High-Dollar, Pre-Pay Reviews Only

As of Jan. 27, 2024, any inquiry submitted through CIR that is not for High-Dollar, Pre-Pay Reviews will be rejected.

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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 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 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 Connection™. 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 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 for access to the most complete and up-to-date information. 

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Stay Informed!

Watch News and Updates for important announcements.

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Provider Training

For dates, times and online registration, visit the Provider Training page.