News & Updates |
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The Importance of Updating Provider Demographics
Failure to do so could result in termination from our network. |
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Medicare Advantage HEDIS Records Collection through June 2024
If Blue Cross and Blue Shield of Oklahoma or Advantmed contact you to provide details about needed records, please promptly provide complete and accurate records. |
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Federal Employee Program® Updates to Prior Approval Requirements and Benefits
Please make note of the FEP® policy type changes, as Jan. 1, 2024. |
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Closing Gaps in Colon Care
We track a quality measure on preventive colorectal cancer screenings for our members ages 45 to 75 to help monitor and close gaps in their care.
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Pharmacy Program Quarterly Update Changes Effective April 1, 2024 – Part 1
Don't miss the pharmacy program quarterly changes that are effective as of April 1. |
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Follow-up Care for Mental Health
You can help our members by encouraging follow-up care with behavioral health care providers when appropriate. |
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Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
Our behavioral health clinical practice guidelines have evidence-based information related to anxiety disorders. |
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Reminder: Update Your Records with New Mailing Address for Paper Commercial Claims and Inquiries
Do not miss this important address change for your mailing records. |
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Use the National Drug Codes Units Calculator Available in Availity® Essentials
Providers will continue to have access to the NDC Units Calculator via Availity Essentials. |
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See Our Revised Clinical Payment and Coding Policy for Anesthesia Services
We will no longer offer additional reimbursement for services based on the use of physical status (P code) modifiers when appended to anesthesia services. |
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Web Changes |
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ClaimsXten™ Quarterly Updates |
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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 |
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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 |
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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 |
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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 |
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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 |
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Do you have a helpful suggestion or feedback about our website? Fill out our Feedback Survey. |
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Provider Training
For dates, times and online registration, visit the Provider Training page.
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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.
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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
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1400 S. Boston, Tulsa, OK 74119
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