Blue Review – Mayl 2018
A Provider Publication |
May 2018
News & Updates
Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2018
Based on the availability of new prescription medications and Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some additions, revisions (drugs still covered but moved to a higher out-of-pocket payment level) and/or exclusions (drugs no longer covered) were made to the Blue Cross and Blue Shield of Oklahoma (BCBSOK) drug lists. Your patient(s) may ask you about therapeutic or lower cost alternatives if their medication is affected by one of these changes.
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REMINDER: Services Rendered by Providers to Related Members and/or Self
Standard Blue Cross and Blue Shield of Oklahoma (BCBSOK) benefits exclude coverage for services and supplies received by a BCBSOK member from a provider in the member’s immediate family.
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May Is Mental Health Awareness Month
Early engagement and interventions are crucial for improved mental health outcomes. As such, access the Magellan Healthcare® Behavioral Health Toolkit for the information necessary to assist in making behavioral health referrals and assessments.
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Meditation Brings Sharper Focus to the Workplace
This story highlights the benefits of taking a few minutes in the workday to reboot, or meditate. A study released last year by the Centers for Disease Control and Prevention says that mindfulness-based practices can improve worker’s health, increase productivity and reduce employers’ costs.
At Blue Cross and Blue Shield of Oklahoma (BCBSOK), we believe that having access to affordable, quality coverage can make a positive, and often profound, difference in our members’ lives. Making the Health Care System WorkSM is BCBSOK’s online magazine that helps tell our story and explore ways we can all work together to help make the health care system work better for everyone. Insurers, providers, employers and members all have a vital role to play in finding new solutions for the future.
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Feature Tip
How to Navigate Our Updated Provider Finder®
Blue Cross and Blue Shield of Oklahoma (BCBSOK) has recently updated the Provider Finder tool on bcbsok.com. The updated Provider Finder optimizes search results so that our members can more easily locate in-network physicians, specialists and other health care providers.
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In the Community
Nominations Open for 2018 Champions of Health Awards
Individuals, groups and organizations that are working to positively change the health status of Oklahomans through unique and innovative programs are encouraged to apply for the 2018 Champions of Health awards. Nominations will be accepted online through May 25.
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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.
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.
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Web Changes
- Posted April Blue Review to Education and Reference Center/News and Updates/Blue Review page
- Posted Pharmacy Program Updates: Quarterly Changes Effective April 1, 2018 to Pharmacy Program
- Posted 2018 Billing and Documentation Guidelines-Drug Testing to Related Resources/Standards and Requirements
Stay Informed
Watch the News and Updates on our Provider website for important announcements.
Update Your Information
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.
Provider Training
For dates, times and online registration, visit the Provider Training page.
Making the Health Care System Work. Better. Together.
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.
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.
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