News and Updates

Insurers Now Required by CMS to Conduct Audit for ACA's Risk Adjustment Program

Starting in 2016, the Centers for Medicare and Medicaid Services (CMS) requires an annual Initial Validation Audit (IVA) to ensure high quality data is used when assessing the payment transfers for the Affordable Care Act's (ACA) Risk Adjustment (RA) program. Therefore, Blue Cross and Blue Shield of Oklahoma (BCBSOK) is asking for your cooperation and participation in the required Initial Validation Audit (IVA). Read More

Prescription Drug List Updates Now Available

Most BCBSOK health plans are subject to a prescription drug list, also known as a formulary. Help your patients get the most out of their prescription drug coverage by checking the current drug list. Read More

Updated iExchange Webinars available

BCBSOK’s automated preauthorization tool — Aerial^TM iExchange^® (iExchange) — supports direct submission of referrals and provides online approval of benefits for inpatient admissions, as well as select outpatient, pharmacy and behavioral services 24 hours a day, seven days a week — with the exception of every third Sunday of the month when the system will be unavailable from 11 a.m. to 3 p.m. (CT). iExchange is accessible to physicians, professional providers and facilities contracted with BCBSOK.

The following iExchange 2016 Enhancement training webinars are available:

• April 13, 2016 – 11:00 to 12 p.m. CT 
• May 11, 2016 – 11:00 to 12 p.m. CT 
• June 8, 2016 – 11:00 to 12 p.m. CT 

ClaimsXten^TM 1st Quarter 2016 Updates and New Rule Notification

Blue Cross and Blue Shield of Oklahoma (BCBSOK) reviews new and revised Current Procedural Terminology (CPT^®) and HCPCS codes on a quarterly basis. Codes are periodically added to/or deleted from the ClaimsXten code auditing tool software by McKesson and are not considered changes to the software version. BCBSOK will normally load this additional data to the BCBSOK claim processing system within 60 to 90 days after receipt from McKesson and will confirm the effective date on the BCBSOK Provider website. Advance notification of updates to the ClaimsXten software version (i.e., change from ClaimsXten version 4.1 to 4.4) will continue to be posted on the BCBSOK Provider website. Read More

ClaimsXten^TM 1st Quarter 2016 Updates and Age-Specific Code Replacement Rule Implementation

Blue Cross and Blue Shield of Oklahoma (BCBSOK) reviews new and revised Current Procedural Terminology (CPT^®) and HCPCS codes on a quarterly basis. Codes are periodically added to/or deleted from the ClaimsXten code auditing tool software by McKesson and are not considered changes to the software version. BCBSOK will normally load this additional data to the BCBSOK claim processing system within 60 to 90 days after receipt from McKesson and will confirm the effective date on the BCBSOK Provider website. Advance notification of updates to the ClaimsXten software version (i.e., change from ClaimsXten version 4.1 to 4.4) will continue to be posted on the BCBSOK Provider website. Read More

Infusion Site of Care Management Program to Target Select BCBSOK Members

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is working with Coram^® CVS/specialty Infusion Services (Coram) to identify members* who may benefit from hearing about Coram’s infusion care services. These services can be offered in the member’s home, at a Coram infusion suite or select CVS/pharmacy^® locations. Read More

Keeping BCBSOK Member Private Health Information Safe

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is committed to protecting our members' health information. BCBSOK Members may have received facts on our Notice of Privacy Practices (NOPP) on an Explanation of Benefits or ID card mailer.

Members may access BCBSOK’s full NOPP three different ways: