BCBSOK Authorization to Disclose Protected Health Information [File: 33 KB] - This form authorizes Blue Cross and Blue Shield of Oklahoma to disclose protected health information only to those individuals specified by the member. Protected health information is defined by privacy rules enacted under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. - [Updated 10/01/07]
BlueLincs Authorization to Disclose Protected Health Information [File: 61 KB] - This form authorizes BlueLincs HMO to disclose protected health information only to those individuals specified by the member. Protected health information is defined by privacy rules enacted under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. - [Updated 9/20/05]
CMS-1500 User Guide [File: 98 KB] - [Updated May 2008] This guide will help providers complete the CMS-1500 (08/05) form for patients with Blue Cross and Shield of Oklahoma insurance.
CPT-4 Modifier Use in Claims Processing [File: 81 KB] - Information about using modifiers when submitting claims to Blue Cross and Blue Shield of Oklahoma. - [Updated 9/20/05]
Synagis Statement of Medical Necessity [File: 195 KB] - [Updated 09/18/09] - This form is for the predetermination/authorization of the medication Synagis used in the prevention of respiratory syncytial virus (RSV).
UB-04 User Guide [File: 223 KB] - [Updated 9/11/08] - This guide will help providers complete the UB-04 form for patients with Blue Cross (facility) coverage.