News and Updates
Beyond the ACO: Building a Better Health Care Reimbursement Model

The health care industry is at a crossroads in terms of how care is delivered. In his latest Huffington Post column, Chief Medical Officer Dr. Stephen Ondra talks about a variety of approaches to “fee-for-value” provider reimbursement. Read More

Blue Cross and Blue Shield of Oklahoma Launches Updated App with Convenient Access to Benefits Information 
App Allows for Mobile Access to Claims, Benefits Coverage, Deductible Amounts and Member ID Cards

Blue Cross and Blue Shield of Oklahoma (BCBSOK) makes health care benefits information available at members’ fingertips with its newly redesigned app.¹ Available in both English and Spanish, the updated app provides access to important benefit information such as claims status and co-pay, deductible and out-of-pocket amounts. Read More

BCBSOK Blue Care Connection^® Elite Member Video Now Available      

Blue Cross and Blue Shield of Oklahoma (BCBSOK) recently developed a Blue Care Connection^® Elite (BCC Elite) video for members to provide a better understanding of the BCC Elite program. Read More

Claim Summary Explanation- Managed Care Withholding Reason Code PR104

A Claims Summary is an explanation of claims submission. You can use the claims summary to determine how a claim was processed, including non-allowed amounts or adjustments. It will note any appropriate deductible and coinsurance amounts that are the responsibility of the member and any non-allowed amounts that are the responsibility of the member or the provider.
Read More

2016 - Second Quarter Availity™ 101 "Back to Basics" Webinars

Register Today for a "BCBSOK Back to Basics: Availity^TM 101" Webinar
Blue Cross and Blue Shield of Oklahoma (BCBSOK) will present "BCBSOK Back to Basics: Availity 101", a complimentary webinar covering the self-service electronic tools and features that can be accessed through the Availity^TM Web portal. Read More

Educational Video Available for BCBSOK Individual Members

Individuals who recently purchased an Affordable Care Act (ACA) plan through Blue Cross and Blue Shield of Oklahoma (BCBSOK) may have questions on how their insurance coverage works. To help answer these questions for your patients, our members, BCBSOK has created an educational video called Meet Your Plan. This video describes the basics of how members can best use their plan and provides information on the available wellness tools http://www.meetyourplanok.com/.

The remittance viewer offers providers and billing services a convenient way to view and help reconcile claim data provided by Blue Cross and Blue Shield of Oklahoma (BCBSOK) in the 835 Electronic Remittance Advice (ERA). Read More

Feature Tip

BCBSOK Releases Additional Help Desk Videos

Blue Cross and Blue Shield of Oklahoma (BCBSOK) recently released a fourth series of member help desk videos. Topics for this series focus on how to manage chronic conditions.  Read More

In the Community

Oklahoma City Students Enjoy Fun Activities at the Bart & Nadia Sports Experience

BCBSOK was a proud sponsor of the Bart & Nadia Sports Experience in Oklahoma City from Feb. 12-14. The event featured a Kid’s Day on Feb. 12, where Oklahoma City-area students were able to enjoy a wide variety of sports and fitness activities, such as kayaking, judo, tennis, soccer, basketball, rowing, softball, gymnastics and crossfit activities. Blaze the Braggin’ Blue Dragon also made an appearance for BCBSOK and educated kids on ways to Be Smart - Don’t Start. Read More

Web Changes

• Posted February Blue Review to Education and Reference Center/News and Updates/Blue Review page.

• Updated On-Set Date/Occurence Date information to Claims and Eligibility/Claim Tips page.

• Updated Availity 101 “Back to Basics” Webinar Schedule to Education and Reference Center/Training/Availity page.

• Updated Remittance Viewer Webinars to Education and Reference Center/Provider Tools/Remittance Viewer page.

Provider Data and Directory Updates

Maintaining accurate provider data and directories are an important part of providing Blue Cross and Blue Shield of Oklahoma (BCBSOK) members with the information they need to manage their health. Please review our online provider directory, Provider Finder. The directory is a helpful tool for providers to refer their BCBSOK patients to other participating providers. Read More

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.