Coming Soon: 2024 Provider Availability and Access Survey

This year’s first survey will be sent between July 19-29. If selected to participate, you will be asked to complete a short, 5-10-minute survey.

Earn Continuing Education Credit: Webinar on Avoiding Inappropriate Antibiotic Use

Join us for free webinar on preventing antibiotics overuse on July 17, 2024, from 9 to 10 a.m.

Physician Performance Insights Reports Coming in August from PEAQ^SM

These reports show how physicians compare to their peers and include information on improving performance.

Pharmacy Program Quarterly Update — Part 2 Changes Effective July 1, 2024

Check out these pharmacy program changes for the third quarter.

New Coupe Health Plan: Update Your Member Records

Under this plan, providers won’t collect copays. Instead, Blue Cross and Blue Shield of Oklahoma will reimburse you directly for the full allowed amount, including the member share.

GLP-1 New to Therapy Optional Benefit Program Available for Select Commercial Members

This program aims to reduce drug waste and cost of care associated with beginning GLP-1 drug therapy.

In-Home Test Kits for Colorectal Cancer Screening

You may want to encourage our members who are your patients to take advantage of this opportunity to learn more about their health with a FIT kit.

Encourage Routine Vaccines and Well-Care Visits for Children and Teens

We track these Healthcare Effectiveness Data and Information Set measures developed by the NCQA to help close gaps in our members’ care.

Provider Rights and Responsibilities

Understand your rights and responsibilities as a participating provider.

Member Rights and Responsibilities

Review the rights and responsibilities of members in BCBSOK.

Cultural Awareness Webinars: No-Cost Continuing Education Credit

Don’t miss these opportunities to increase your awareness on important patient care topics at no cost to you.

See Our Revised Coding for Consultation Services in the Clinical Payment and Coding Policy for Evaluation and Management CPCP024

Check out this revision in coding for Consultation Services in the Clinical Payment and Coding Policy.

Prior Authorization Requests May Be Needed Due to Pharmacy Claims Processing Error

Prior authorization programs include Acute Migraine, GLP-1 Agonists, Topiramate ER and Winlevi.

Proper Billing for Supplies for Transcutaneous Electrical Nerve Stimulation Units

This helps eliminates additional costs to you and our members.

Prior Authorization Codes Updated for Commercial Members Effective Oct. 1

BCBSOK is changing prior authorization requirements that may apply to some commercial members to reflect new, replaced or removed codes.

Prior Authorization Codes Updated for Medicare Advantage Effective Oct. 1

BCBSOK is changing prior authorization requirements for Medicare Advantage members to reflect new, replaced or removed codes.

ClaimsXten^TM 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 to be evaluated during the claim adjudication process, you can continue to use Clear Claim Connection^TM. 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.