| Jan. 8, 2015 News & Updates Affordable Care Act in Action: Grace Periods
The second open enrollment period for consumers shopping on the Health Insurance Marketplace began Nov. 15, 2014, and enrollment for 2015 will remain open through Feb. 15, 2015. ClaimsXtenTM to Add Correct Coding Initiative Rule
Beginning on or after March 23, 2015, Blue Cross and Blue Shield of Oklahoma (BCBSOK) will enhance the ClaimsXten code auditing tool by adding the Centers for Medicare & Medicaid Services (CMS) Correct Coding Initiative Rule into our claim processing system. This will help to identify claims containing code pairs found to be unbundled according to the CMS initiative. Pharmacy Program Updates: Pharmacy Program Changes Effective Jan. 1, 2015
BCBSOK pharmacy program updates are typically published on a quarterly basis in Blue Review and/or on our provider website to help keep you informed of standard drug list additions/deletions, dispensing limit changes and utilization management program enhancements. Get a summary of changes effective Jan. 1, 2015. Controlled Substance Program Reports Positive Outcomes
In mid-2014, we enhanced our Controlled Substance Program to better identify and assist members with controlled substance utilization patterns indicating potential abuse and misuse. Read about some of the positive outcomes our review team has reported. What’s New on iExchange®: Enhancements and Webinars
Check out our recent enhancements to iExchange, our online tool that allows providers to conduct benefit preauthorization requests for inpatient admissions/extensions, and more recently, select behavioral health, pharmacy, and medical/surgical services. Also, join one of our free webinars to learn more about the tool. Diagnosis and Medical Management of Sleep Related Breathing Disorders
The purpose of this article is to provide you with a brief overview of recent updates to the BCBSOK Diagnosis and Medical Management of Sleep Related Breathing Disorders Medical Policy (MED205.001). The changes below will be effective for dates of service beginning April 15, 2015. Professional Provider Network Representative Territory Assignment Update
BCBSOK recently redistributed the professional provider territory assignment and updated the maps on our website. Review the updates. Operator of BCBSOK Nationally Recognized For Outstanding Commitment to Community
The operator of BCBSOK has been recognized as one of America’s most community-minded companies as part of The Civic 50. The Civic 50 honors the 50 most community-minded companies in the nation each year. In Every Issue Featured Tip: Provider Medical License Lapses and Network Participation
BCBSOK reviews and validates the professional qualifications of physicians and certain other providers who apply for participation with our health care organization. If your Oklahoma license lapses for any period of time, your participation will be in jeopardy of termination. Learn more. In the Community: Blue Cross Sponsors 2014 Route 66 Marathon
BCBSOK is proud to sponsor the 2014 Route 66 Marathon and the Blue Cross and Blue Shield of Oklahoma Corporate Challenge in Tulsa. Web Changes BCBSOK Online Provider Orientation
The Online Provider Orientation is a convenient and helpful way for providers to learn about the online resources available to them. Medical Policy Reminder
Approved new or revised BCBSOK medical policies and their effective dates are posted on the BCBSOK website the first day of each month. These policies may impact your reimbursement and your patients’ benefits. You may 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 provider website. While some information on new or revised medical policies may occasionally be published for your convenience, please visit bcbsok.com/provider for access to the most complete and up-to-date information. 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. | 