Blue Cross and Blue Shield of Oklahoma (BCBSOK) manages health services for all members who have behavioral health benefits through a variety of group, government and retail products. Similar behavioral health programs are implemented across product lines but may be modified or enhanced dependent upon the product.
BCBSOK administers behavioral health benefits for BlueLincs HMO members.
Federal Employees Program (FEP) members are managed by BCBSOK. FEP members must request preauthorization for Applied Behavior Analysis (ABA) services but are not required to request preauthorization for any other outpatient behavioral health services including Partial Hospitalization Programs.
Behavioral health care management is integrated with our medical care management program, to help members access their behavioral health benefits and to improve coordination of care between medical and behavioral health providers.
This program will help BCBSOK clinical staff identify members who could benefit from co-management earlier, and may result in:
- Improved outcomes
- Enhanced continuity of care
- Greater clinical efficiencies
- Reduced costs over time
Some members* may be referred to other medical care management programs that are designed to help identify and help close potential gaps in care through evidence-based and member-focused approaches to health care and benefit decisions.
All behavioral health benefits are subject to the terms and conditions as listed in the member's benefit plan.
* Members experiencing inpatient hospitalization, complex or special health care needs or who are at risk for medical complications may be referred to medical care management programs through a variety of mechanisms such as predictive modeling, claim utilization, inbound calls, self-referrals, and physician referrals. If members do not have medical care management programs as part of their group health plans, they will not be referred to other medical care management programs.