Clinical Practice Guidelines

Blue Cross and Blue Shield of Oklahoma (BCBSOK) uses evidence-based clinical guidelines from nationally recognized sources to guide our quality and health management programs. Guidelines are designed to support the decision-making processes in patient care. Recommendations from other national entities may vary.

Clinical Practice Guidelines (CPGs) and Preventive Care Guidelines are adopted by BCBSOK and are the foundation for selected Condition Management Programs. These guidelines are based on established evidence-based standards of care, publicized by specialty societies and national clinical organizations. These guidelines are updated at least every 2 years and when new significant findings or major advancements in evidence-based practices and standards of care are established.

You may request a hard copy of a CPG by calling 866-670-6681. If you would like to comment on the CPGs adopted by BCBSOK, please email OKQADepartment@bcbsok.com.

CPGs are meant to serve as general guidelines and are not intended to substitute for clinical judgment in individual cases. At this time, BCBSOK endorses the American Academy of Family Physicians and American College of Physicians criteria for defining high blood pressure, which varies from the values provided in other guidelines. Providers are encouraged to make decisions based on their own judgement and most current evidence-based information available. The links below provide information about the CPGs:

Shared Decision-Making Aids

Shared decision-making is a communications process. It’s a way for providers and patients to make informed health care decisions that align with what matters most to patients. Below are resources to help you involve your patients in shared decision-making.

These evidence-based aids provide information about treatment options, lifestyle changes and outcomes. They don’t replace your guidance but can help your conversations with patients.

Why it’s important: When patients help make decisions about their health care, it can lead to improved patient experience, better outcomes, and quality of life.