BLUE REVIEW^SM

May 2024

Electronic Claim Review and Ensuring the Correct Use of our Claim Review Form

Electronic claim review through Availity^® Essentials is fast, easy and the preferred method of submission.

If you do not have Availity access, use our Claim Review Form. In order to complete a proper claim review with Blue Cross and Blue Shield of Oklahoma, you must provide all the information requested. Effective Aug. 1, 2024, we’ll return any incomplete form without conducting the claim review.

Here are some helpful tips when submitting a claim review form:

• These requests are only to be used for review of a previously adjudicated claim.
• Don’t attach the original claims to a review form, rather, you’ll reference the claim number in the appropriate field on the form.
• Don’t use this form to submit a corrected claim, instead, use our Corrected Claim Form.
• Don’t use this form to respond to an additional information request. Use the Additional Information Form.
• If you submit this form as a request for a second review, you must provide information not previously submitted for the review to be eligible.

Reminder: Electronic submission is your fastest path to an efficient claim review at Availity. Be sure to provide all required information as we won’t review electronic inquiries received with incomplete information.

Submit a Claim Review Online, Fast
To submit an online claim review request via Availity:

• First, perform a Claim Status search utilizing the Member or Claim tab
• Second, use the Dispute Claim or Message This Payer option to request a claim review
• Third, complete all needed information

More Information
Learn more at our Claims Tips web page.