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For Providers
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May 2025 |
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MAY SPOTLIGHT |
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Reinforce Prenatal and Postpartum Care to Support Whole Health
We track quality measures related to our members’ care visits and depression screening during and after pregnancy. Review tips to close gaps in care.
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CLAIMS AND ELIGIBILITY |
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Watch for New Virtual Card Payments for Member Cost Share
The MasterCard® payments cover a portion of cost share for some members on Luminare Health® benefit plans, including Oklahoma City Firefighters. Learn about processing the payments if you receive them by mail.
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Take Note of Prior Authorization Changes for Commercial and Government Programs
Effective July 1, 2025, prior authorization requirements for certain commercial and government plans are changing to reflect new, replaced or removed codes.
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EDUCATION |
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Explore Learning Opportunities
We offer free training for providers who participate in our networks. Sign up for sessions, including coding webinars that offer continuing education units.
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NETWORK PARTICIPATION |
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Looking for Help?
Do you know the fastest way to get a response on prior authorizations? Are you aware of the latest pharmacy drug updates, or do you have a claims question? You can find many answers on our provider website, including:
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• The latest updates
• Details about tools to streamline billing and processes
• Tips for newly contracted providers
• Quick reference links
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Contact Your Provider Relations Representative
If you have a question and can’t find an answer, our Provider Relations Representatives are here to help. Email us or call 800‑722‑3730 and select Option 2 for network.
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PHARMACY |
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Pharmacy Program Quarterly Update – Part 2
Changes were made to our drug lists and utilization management program. Learn about these and other pharmacy program updates.
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STANDARDS AND REQUIREMENTS |
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Learn about Updates to Clinical Payment and Coding Policies
We regularly add and modify our CPCPs as part of our ongoing policy review. See which policies were updated and when.
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Review Medical Policy Updates
Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.
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Contact Us
Contact information for Provider Relations Representatives and other resources is on our website.
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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 Ave., Tulsa, OK 74119
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