Blue Review – Oklahoma Division

BlueCross BlueShield of Oklahoma
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Blue Review

For Providers

March 2024


News & Updates

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

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.