| Feb. 5, 2015 News & Updates Urine Drug Testing Policy, Effective Dec. 15, 2014
Effective this past December, Blue Cross and Blue Shield of Oklahoma (BCBSOK) has a new urine drug testing policy that addresses the overuse of the quantitative/confirmatory procedure. Please familiarize yourself with the policy. 2014 HEDIS® Antidepressant Medication Management Results
The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool that measures performance on important dimensions of care and service, including behavioral health. Learn more about the BCBSOK member results compared to national averages. ClaimsXtenTM Updates – First Quarter 2015
BCBSOK reviews new and revised Current Procedural Terminology (CPT®) and HCPCS codes on a quarterly basis. Beginning on or after April 20, BCBSOK will enhance the ClaimsXten code auditing tool by adding the first quarter 2015 codes and bundling logic into our claim processing system. Learn more. New Effective Date for Sleep Study Medical Policy Updates
Review the recent revisions to the BCBSOK Medical Policy (MED205.001), Diagnosis and Medical Management of Sleep Related Breathing Disorders. The new effective date for this medical policy has been extended to May 1, 2015. Legislative Update: Expedited Formulary Exception Process for Urgent Circumstances
Beginning with coverage years on or after Jan. 1, 2015, issuers providing essential health benefits must provide consumers with an expedited formulary exception process for urgent circumstances that exist under specific circumstances. Review what those circumstances are. Anthem® Blue Cross and Blue Shield Introduces Cancer Care Quality Program
Effective Jan. 1, 2015, Anthem Blue Cross and Blue Shield implemented a Cancer Care Quality Program administered through AIM Specialty HealthSM. While this program is not applicable to other Blue Plan members, we are sharing information about this program since it is offered to both national and local Anthem members. Medical Director’s Minute – Dr. Greg Marino
 Eye exams are crucial for people with diabetes. BCBSOK’s Medical Director shares trends and important information that may be overlooked in regards to diabetes. Read more. In Every Issue Featured Tip: Reminder – Insulin Formulary Changes and New Prior Authorization Program for 2015
Starting Jan. 1, 2015, for non-Medicare Part D or Medicaid members with Blue Cross and Blue Shield of Oklahoma prescription drug coverage, Novolin, Novolog, Lantus and Levemir are preferred insulin brands and process at the member’s preferred brand copay. Humulin, Humalog and Apidra are non-preferred brands, and depending on the member's benefit plan, may require a prior authorization request to be submitted and approved for coverage consideration. See the article published on Jan. 6, 2014, for more information. In the Community: Oklahoma Caring Foundation Partners with Oklahoma City Area Inter-Tribal Health Board to Reveal New Caring Van
The Oklahoma Caring Foundation recently revealed a brand new Caring Van that will serve American Indians statewide. Learn more. 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. | 