Reminder: Provider Satisfaction Survey 2024

The survey measures your satisfaction with Blue Cross and Blue Shield of Oklahoma and identifies areas where we can improve.

The Importance of Updating Provider Demographics

Directory information must be verified every 90 days under federal law, even if your data hasn’t changed.

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

Don’t miss these pharmacy changes for the third quarter.

ClaimsXten^TM Quarterly Update Effective Aug. 19, 2024

Code updates may include additions, deletions and revisions to Current Procedural Terminology and/or Healthcare Common Procedure Coding System codes.

Behavioral Health Consultations During Hospitalization Can Improve Outcomes

We encourage hospital staff/attending providers to consider consultations and follow-up care coordination when appropriate.

Helping Our Members Manage Diabetes

You play an important role in supporting our members with diabetes through regular screenings, tests and office visits.

Medical Records Reminder for Group Medicare Advantage (PPO) Members

If we need medical records for members of Blue Cross Group Medicare Advantage (PPO)^SM, you will receive requests from Blue Cross and Blue Shield of Oklahoma or our vendor, Advantmed, as part of the Blue Cross and Blue Shield National Coordination of Care program. Please respond promptly to our requests so that we may provide timely service to those Medicare Advantage members.

Updated PEAQ^SM Methodology Is Now Available

The methodology explains how PEAQ evaluates physician performance.

Location requests now only accepted through the Demographic Change Form

Please note this change when you need to make an additional location request.

New: Access MCG Care Guidelines Clinical Criteria via Availity^®

Clinical rationale outlined in provider correspondence and in some Clinical Payment and Coding Policies will guide you to the specific guidelines, when applicable.

Update: Our Revised Clinical Payment and Coding Policy for Anesthesia Services now Effective Aug. 14, 2024

This change will impact reimbursement with P codes when appended to anesthesia services.

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 BCBSOK 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.