Nov. 5, 2015 News & Updates
Blue Cross Medicare AdvantageSM Prior Authorization List Effective Jan. 1, 2016
Access the 2016 Blue Cross Medicare Advantage Prior Authorization List on the Blue Cross and Blue Shield of Oklahoma (BCBSOK) provider website. This list goes into effect on Jan. 1, 2016. Provider Claim Summary Update: ‘Ntwk Diff’ Column
Recently, you may have noticed a new column titled "Ntwk Diff” that has been appearing on some of your patients’ Provider Claim Summaries (PCSs). An August 2015 coding change is the cause of this unintended occurrence. There are no financial impacts associated with this anomaly to either your practice or the member's claim record on which this column may appear. A solution to prevent this erroneous column from being displayed on the PCS was implemented in early October. More Enhancements Coming to the iExchange® Benefit Preauthorization Tool
We’ve made enhancements and continue to improve iExchange, our Web-based benefit preauthorization tool. iExchange supports requests for Behavioral Health, Pharmacy and Medical/Surgical Treatment services. Behavioral Health Utilization Management Affirmation Statement
Read about the BCBSOK Utilization Management affirmation statement. Access to Care for BCBSOK Members
The BCBSOK Quality Improvement Program implements mechanisms to identify, monitor, evaluate and resolve issues that impact the accessibility, availability, continuity, and quality of care and service provided to our members. BCBSOK monitors access and availability to medical and behavioral health care services and requires corrective action for improvement as identified. To review the BCBSOK patient access to care standards, please visit the Quality Improvement Web page located at bcbsok.com/provider. Important Information for BCBSOK Providers
Read about member health insurance plan rights. Find out What’s Ahead on the Retail Marketplace at a Provider Education Session
Register for one of two online webinars to learn about the Health Insurance Marketplace and more. Links to the webinars are included. Nov. 11 Remittance Viewer Webinar Reminder
If you’re looking for a faster, easier way to view your claim payment information from BCBSOK, we invite you to use remittance viewer. Learn about the convenient online tool at a webinar on Nov. 11. The link to sign up is included. Chief Medical Officer Now a Contributor to The Huffington Post
Check out Chief Medical Officer Dr. Stephen Ondra’s article in The Huffington Post about the need for greater price transparency in health care and what our company is doing about it. In the Community
Exciting Year for Oklahoma Caring Foundation in 2015
The Oklahoma Caring Foundation has added two new Oklahoma Caring Vans this year, and another one will be added this fall. #StayFocusedOK: Stop Texting While Driving
BCBSOK supports the Trooper Nicholas Dees and Trooper Keith Burch Act of 2015. This law prohibits any person operating a motor vehicle from using a hand-held electronic communication device to manually compose, send or read an electronic text message while the motor vehicle is in motion. Throughout the month of November, BCBSOK will be tweeting facts about the dangers of texting while driving. Oklahoma Champions of Health Winners Recognized at Gala
Organizations making a positive impact on the health of Oklahomans were honored at the 2015 Champions of Health Gala. Web Changes - Posted October Blue Review to Education and Reference Center/News and Updates/Blue Review page
- Updated ICD-10 page to Standards and Requirements/ICD-10
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/Contract Request Form 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 change. For more information, please contact your BCBSOK Provider Network Representative. 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. | 