Blue Review Provider Newsletter

Our Blue Review provider newsletter is released monthly so that you and your staff have the latest news on claims and billing, federal mandates, medical policies, condition management programs, practice guidelines, formulary/drug list updates, Medicaid, BlueCard, and educational webinars.

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August 2019 

  • Member Letters Have a New Look!
  • Availity® Claim Research Tool Offers Enhanced Claim Status Results
  • Automated Phone System Offers More Service Options for Medicare Advantage
  • Bringing Millennial Health into the 21st Century

July 2019 

  • Changes to Behavioral Health Claim Review Coming
  • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2019
  • Reporting On-Demand Application Now Available for Medicare Advantage via Availity® Provider Portal

June 2019 

  • In-home Colorectal Cancer Screening Test Provided to Select Members
  • 2019 HHS-Risk Adjustment Data Validation Program (RADV)
  • Imaging Studies for Low Back Pain

May 2019 

  • Change in Reject Notification for Invalid National Drug Codes (NDCs) Used on Electronic Medicare Advantage Claims
  • Check Your Patients? Behavioral Health Preauthorization Requirements
  • Save Time by Using eviCore Web Portal for Preauthorization Requests

April 2019 

  • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2019
  • Check Eligibility and Benefits: Don’t Skip This Important First Step!
  • BCBSOK’s Payer Spaces Updates in Availity® Provider Portal

March 2019 

  • 2019 Standards of Medical Care in Diabetes
  • BCBSOK's Payer Spaces Updates in Availity® Provider Portal
  • Government Programs: Verifying Claim Status in the Availity® Provider Portal

February 2019 

  • 2019 Updates to the Behavioral Health Request Forms
  • Automated Phone System Change for Behavioral Health Services
  • New Opioid Drug Management Program for Medicare Members

January 2019 

  • BCBSOK Expansion or Changes to Preauthorization Requirements Beginning Jan. 1, 2019
  • 2019 Holiday Schedule Reminders (for 835 and 837 transactions)
  • Blue Cross Medicare AdvantageSM Prior Authorization List Effective 1/1/2019

December 2018 

  • New Benefit Preauthorization Requirements for Select Infusion Drugs
  • BCBSOK Expansion or Changes to Preauthorization Requirements Beginning Jan. 1, 2019
  • Medicare Advantage: Preauthorization Change for Psychological and Neuropsychological Testing

November 2018 

  • In-home Colorectal Cancer Screening Test
  • Changes to Home-Based Sleep Study Benefit Prior Approval Requirements for Some FEP Members
  • Prepping for the 2018-2019 Flu Season

October 2018 

  • Prepping for the 2018-2019 Flu Season
  • Close HEDIS® Gaps easily through the Availity® Provider
  • Quickly, Efficiently Manage and Respond to Coding Opportunities Online through the Availity® Provider Portal

September 2018 

  • New President Named for BCBSOK
  • New Lactation Consultation Designation added to Demographic Change Form
  • Important Reminder: Claims Will Deny if Rendering NPIs are not on File with BCBSOK

August 2018 

  • Appropriate Use of Opioids Program Launched August 1, 2018
  • Voluntary Recall of Medications Containing the Valsartan Active Ingredient
  • New Preventive Service for Medicare Members at Risk for Type 2 Diabetes

July 2018 

  • Ensure Accuracy of Claims Coding, Billing and Payments
  • High-dose Influenza Vaccine Guidelines
  • Changes Coming to the BCBSOK Predetermination Request Form

June 2018 

  • Billing Qualified Medicare Beneficiary for Medicare
  • Addressing What Matters: How BCBSOK Is Tackling the Opioid Crisis
  • 3rd Quarter AvailityTM, iExchange and Remittance Viewer Training Now Available

May 2018 

  • Pharmacy Program Updates
  • May is Mental health Awareness Month
  • How to Navigate Our Updated Provider Finder
  • Nominations Open for 2018 Champions of Health Awards

April 2018 

  • BCBSOK Approves Coverage of New Shingles Vaccine Shingrix
  • Flu Epidemic Notification from the CDC
  • Updated: Additional Benefit Preauthorization Requirements for 2018

March 2018 

  • Interpreting the ‘PLB’ Segment on the 835 ERA
  • AvailityTM Claim Research Tool Offers Enhanced Claim Status Results
  • How to Keep the Cash Flowing: Helpful Tips for Preventing Claim Delays

February 2018 

  • How providers can impact HEDIS®
  • Referrals Process for American Indians with Limited Cost-sharing Plans
  • Electronic Commerce Services – Hours of Operation Update

January 2018 

  • Notification of Annual Benefit Updates
  • Effective Jan. 1, Sensipar® (cinacalcet) will no longer be separately reimbursable under Medicare Part D for ESRD
  • Skilled Nursing Facility (SNF) Benefit Change for Federal Employee Plan (FEP) Members