Sept. 3, 2015 News & Updates
Changes Slated for Oklahoma Retail Market in 2016
The retail health insurance market has evolved significantly since the opening of the Health Insurance Marketplace in 2014. These changes require Blue Cross and Blue Shield of Oklahoma (BCBSOK) to make adjustments in 2016 that will allow us to continue offering sustainable health insurance options to Oklahomans across the state. Review the changes that become effective Jan. 1, 2016. ICD-10: Important Dates and Resource Reminders
Review important dates about when BCBSOK will begin accepting ICD-10 codes, and access additional information, such as claim submission tips and resource reminders. Using DSM-5 to Identify ICD-10 Codes
Review a brief tutorial on using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in the transition to ICD-10. Considering Mobile Apps for ICD-10?
If you’re considering using a mobile app to bring ICD-10 to your fingertips, then be sure to read our six tips first. Health Summary Now Available in iExchange®
Learn more about the Health Summary – a modification of the Patient Clinical Summary offered previously – as well as using ICD-10 in online benefit preauthorization requests during one of three webinars. Get the dates. Medical Policy Identifies Intranasal Topical Anesthetic Application for Headaches as a Non-covered Service
BCBSOK Medical Policy MED205.039, or Topical Application Device for Anesthetic Treatment to the Sphenopalatine Ganglion for Headaches (treatment of headache or facial pain) will become effective for dates of service on or after Nov. 1, 2015. Specialty Pharmacy Preferred Channel Management, Effective Nov. 1, 2015
Starting Nov. 1, 2015, BCBSOK reimbursement rates are being adjusted for select medications identified as specialty pharmacy products with Preferred Channel Management. Learn more. Online Resources Available for Claim Status
As a reminder, claim status is no longer available through the BCBSOK Interactive Voice Response phone system. This change became effective July 13, 2015. Medicare Marketing Guidelines for Providers
If you are independently contracted with BCBSOK to provide services to our Blue Cross Medicare Advantage (HMO)SM or Blue Cross Medicare Advantage (PPO)SM members, then be sure to review the “Dos” and “Don’ts” established by the Centers for Medicare & Medicaid Services when marketing to potential new members. Modifier 25 Reminders
As a reminder, review seven tips about Modifier 25.The Current Procedural Terminology® codebook defines Modifier 25 as a “significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service.” BCBSOK to Host a Payer-specific Overview of the Availity Web Portal
For most electronic transactions, you will need to enlist the services of a vendor portal for the secure exchange of your patients’ protected health information. Our Provider Education Consultant team is hosting “BCBSOK Back to Basics: AvailityTM 101” webinars to provide an overview of several electronic options, using the Availity Web Portal as one example of a vendor to consider. Register today. The Impact and Benefits of Palliative Care
This is the second article in a three-part series about palliative care. Palliative care emphasizes symptom management, communication, advance care planning, coordinated care by the interdisciplinary team and family/caregiver support. It helps address many unmet needs, and aims to protect against a complicated and sometimes dysfunctional care-delivery system.  Help Your Patients Keep Their Health on Track with The Healthy Family App
Review the functions of the BCBSOK Healthy Family app, and encourage your staff, patients, family and friends to use it! Featured Tip
Seasonal Flu Vaccines Save Lives and Reduce Unnecessary Hospitalizations
Patients win when they are immunized for the flu as they can reduce their risk of being sick, missing work and the need for hospitalization. By increasing the percentage of citizens who receive the influenza vaccine, you and other health care providers can help reduce the burden of influenza and its complications. Read more. In the Community
BCBSOK and Oklahoma Health Care Authority Work to Address Infant Mortality
Learn about the collaboration between BCBSOK and the Oklahoma Health Care Authority to affect the Infant Mortality Rate amongst the African-American community and other ethnic groups. Take the First Step to End Alzheimers
Learn how BCBSOK is working to positively impact Alzheimer's disease. BCBSOK Announces Sponsorship of The Bedlam Series
 BCBSOK is excited to announce their sponsorship of The Bedlam Series. The sponsorship will last throughout the 2015-16 season and includes a variety of collegiate sports matchups between Oklahoma State University and the University of Oklahoma. The events include soccer, golf, cross-country, tennis, track and field, football, wrestling, baseball and softball. Tulsa Shock Health and Wellness Night a Success
 Fun was had by all who attended the Tulsa Shock Health and Wellness Night on Thursday, July 30. BCBSOK mascot Blaze the Braggin’ Blue Dragon participated in several events, including the pre-game ball exchange and Kickin’ Conga Line presented by BCBSOK. The Mobile Assistance Center (MAC) was onsite to answer customer questions, and the Caring Van offered free BMI screenings and free tickets before the game. The MAC’s Christian Gray sang the National Anthem, and many visited the BCBSOK booth to enter for a chance to win free headphones. 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. | 