Jan. 14, 2016

Patient “After Hours” Care

The Blue Cross Blue Shield of Oklahoma (BCBSOK) access standard policies have been updated to include criteria for “After Hours” care. 

You may view the updated Patient Access to Care policies located in the Clinical Resources/Quality Improvement section at bcbsok.com/provider.

The new “After Hours” requirements will be effective Jan. 1, 2016, and are listed below:

• The provider is required to provide access or personal instruction to members 24 hours a day, seven days per week
• This coverage includes instructions to call another number that connects to a person or an office outgoing message that can be returned within one hour
• Out of office messages directing the member to call 911 or to go to the closest emergency room or urgent care center for services alone is unacceptable instruction
• All office calls should be answered and must provide instruction per the above requirements 

If you have any questions regarding this change, please contact your Provider Network Representative.