Nov. 5, 2015

iExchange allows you to submit initial and extension requests for approval prior to services being rendered. We strongly encourage you to verify your patients’ eligibility and benefits to determine coverage and benefit preauthorization requirements prior to using the tool. This flexible tool provides real-time responses for direct submission of inpatient admissions and also select outpatient medical services, including benefit preauthorization submissions after regular business hours and on weekends.

Recently, Blue Cross and Blue Shield of Oklahoma (BCBSOK) deployed what was formerly known as the Patient Clinical Summary. iExchange now offers an updated version called the Health Summary. Providers are able to receive additional data in the Health Summary, including more real-time data. This update is the result of BCBSOK’s efforts to give you access to more data and better analytics that can help improve the health of your patients.

The Health Summary will display the following information:

• Conditions – chronic and acute
• Health status measures
• Plan and care data
• Medications
• Lab and test results/procedures
• Visits 

Coming Soon to iExchange
iExchange will soon support the submission of online requests and required documentation for predetermination for medical necessity. Instead of faxing clinical information, attachments will be able to be submitted electronically. Watch our provider website and Blue Review for more information.

Please note that the fact that a service has been preauthorized/pre-certified is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.