June 2018

Billing Qualified Medicare Beneficiary for Medicare

The Centers for Medicare and Medicaid Services (CMS) has published an article that provides CMS guidance to Medicare providers to help them avoid inappropriately billing Qualified Medicare Beneficiaries (QMB) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.

Addressing What Matters: How BCBSOK Is Tackling the Opioid Crisis

BCBSOK has launched a new web page called Addressing What Matters, where members and stakeholders can view BCBSOK’s perspectives on emerging health care issues and receive important Plan updates. The web page includes a message from Joseph Cunningham, M.D., divisional senior vice president of Health Care Delivery and chief medical officer, and will feature key topics throughout the year. The inaugural topic focuses on how BCBSOK is addressing the opioid public health emergency.

3rd Quarter Availity^TM, iExchange and Remittance Viewer Training Now Available

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is proud to offer complimentary educational webinar sessions to our provider community. BCBSOK is committed to providing personalized one-on-one education to our valued providers. You will experience the maximum result from our training effectiveness which will foster satisfaction with BCBSOK.

Provider Finder^® Updates

Blue Cross and Blue Shield of Oklahoma (BCBSOK) has recently updated the Provider Finder tool, which is accessible via a link on our BCBSOK website. The updated Provider Finder improves search results so that all users can more easily locate in-network physicians, specialists and other health care providers.

Tulsa CARES receives BCBSOK grant for Hepatitis C care and prevention

Over the past two decades, Tulsa CARES has provided a compassionate response to the HIV epidemic as the HIV infection has evolved from a fatal illness to a manageable chronic health condition.

Through the Healthy Kids, Healthy Families^® grant from Blue Cross and Blue Shield of Oklahoma, the organization has expanded their outreach and services and will now be able to assist those living with Hepatitis C virus (HCV).

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.

To update your directory information or other provider information such as tax identification numbers, supervising physician information, hospital privileges, etc., please submit the BCBSOK Provider Notification form via fax to 918-549-2141 or email the form to oknetworkmanagement@bcbsok.com.

All changes should be submitted at least 30 days in advance of the effective date of the change. For more information, please contact your BCBSOK Provider Network Representative.

• Posted May Blue Review to Education and Reference Center/News and Updates/Blue Review page
• Posted Hospital Appeal Submission Tip Sheet to Education and Reference Center/Resources
• Posted Prime Therapeutics and Walgreens Combined Specialty and Home Delivery Pharmacy Services Company Brand Launch Completed Important E-Prescribing Changes to Education and Reference Center/News and Updates/Blue Review page

Watch the News and Updates on our Provider website for important announcements.

Do you need to update your location, phone number, email or other important details on file with BCBSOK? Use our online forms to request an information change.

For dates, times and online registration, visit the Provider Training page.

We have an insider’s view of how health insurers, doctors, hospitals, employers and governments depend on one another to provide access to affordable, high-quality care and help people live healthy, productive lives. We put together a team of writers and multimedia creators to work with business and thought leaders, inside and outside of our organization, to explore ways we can all work together to make the health care system work better for everyone. Learn more about the online magazine we created to tell these stories.

The Online Provider Orientation is a convenient and helpful way for providers to learn about the online resources available to them.

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. 

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.

bcbsok.com/provider

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