Oct. 8, 2015 News & Updates
Completing the Transition to ICD-10
Review some key points about ICD-10 to help make the transition smoother. ICD-10 Direct Data Entry Claim Submission Webinars
Your clearinghouse, practice management system and/or other vendor(s) should be able to support transactions with ICD-10 as of Oct. 1, 2015. However, if they cannot, then you may submit your own electronic claims one-by-one via the AvailityTM Web portal using the Direct Data Entry option. Please join us for one of three webinars this month to learn more. ClaimsXtenTM Edits for Compression Device Accessories, Effective Dec. 14, 2015
Beginning on or after Dec.14, 2015, Blue Cross and Blue Shield of Oklahoma (BCBSOK) will enhance the ClaimsXten code auditing tool by adding incidental edits to our claim processing system for Healthcare Common Procedure Coding System (HCPCS) codes for Compression Device Accessories (such as E0655 through E0673). Find out What’s Ahead on the Retail Marketplace at a Provider Education Session
Blue Cross and Blue Shield of Oklahoma (BCBSOK) is hosting two online education webinars for BCBSOK contracted providers. Find out what you should know about the Health Insurance Marketplace, and more. Pharmacy Program Updates: Pharmacy Changes Effective Oct. 1, 2015
Review the revisions made to the BCBSOK standard drug list that went into effect Oct. 1, 2015. Antipsychotic Drug Use in Elderly Patients with Dementia
The Centers for Medicare & Medicaid Services (CMS) and the CMS National Partnership to Improve Dementia Care in Nursing Homes have set a new goal to achieve a 25 percent reduction in antipsychotic drug use within nursing homes by the end of 2015, with a 30 percent reduction by the end of 2016. Learn what BCBSOK is using to help identify members who have had a claim for an anti-dementia medication and who also have a recent pharmacy claim for an antipsychotic drug. Asthma Care Reminder
The National Institute of Health (NIH) National Asthma Education and Prevention Program recommends that patients with persistent asthma should be treated with an inhaled corticosteroid. Learn what BCBSOK is using to review claims data that it receives to identify members who have had a claim for an asthma rescue inhaler, but have not received an inhaled corticosteroid. Blue Preferred PPOSM Network Has Expanded
BCBSOK’s Blue Preferred PPO network has grown. Learn about the difference that sets Blue Preferred PPO apart from the larger PPO network. Integrated Palliative Care in Action: What Does It Look Like?
This is the third article in a three-part series about palliative care. Because patients and providers will often mistakenly equate palliative care with hospice care, there is confusion as to what role palliative care may play for a patient who is still receiving or who desires disease-focused therapies. Learn more about the integration between attempts to modify disease trajectory and assessments for unmet palliative needs, which span physical, emotional, social and spiritual realms. Web Changes 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. | 