Clinical Resources

Quality Improvement

The Quality Improvement program implements mechanisms to identify, monitor, evaluate, and resolve issues that impact the accessibility, availability, continuity, and quality of care and service provided to our members.

Learn more about the Quality Improvement program.


Recent Utilization and Case Management Changes

In an effort to standardize the Utilization and Case Management processes for Blue Cross and Blue Shield of Oklahoma, changes have recently taken effect. Learn about these new changes and updates.


Oklahoma Preauthorization Requirements

Preadmission Certification (precertification) and Admission Certification are processes used in order to determine that services are medically necessary. Find out about requirements, how to request precertification and other vital information.


Right to Offset

Blue Cross and Blue Shield of Oklahoma has the contractual "Right to Offset." This right allows us to retract overpayment amounts from future payments. Learn about notification, processes and other important information.


Behavioral Health Program

Information about the changes to the Blue Cross and Blue Shield of Oklahoma Behavioral Health Program effective January 1, 2011. Learn more about the Behavioral Health Care Management Program.


Bridges to Excellence

BCBSOK is licensed as a sponsor of the Bridges to Excellence® (BTE) Diabetic Care Recognition program and Cardiac Care Recognition programs. Learn more about Bridges to Excellence.


Clinical Practice Guidelines

Clinical Practice Guidelines (CPGs) are adopted by BCBSOK, and are incorporated into Condition Management Programs. Learn more about Clinical Practice Guidelines.