Change to Some Primary and Secondary Claims Coordination

Oct. 7, 2021

Beginning Dec. 13, 2021, when a Blue Cross and Blue Shield of Oklahoma (BCBSOK) member has primary and secondary health insurance coverage from two BCBSOK plans, or BCBSOK and one of these four plans listed below, we will be making changes to increase efficiencies in coordinating these claims for our providers.

  • Blue Cross and Blue Shield of Illinois
  • Blue Cross and Blue Shield of New Mexico
  • Blue Cross and Blue Shield of Montana
  • Blue Cross and Blue Shield of Texas

These changes will decrease the time it takes to process and coordinate payment of these claims. This is for members with a BCBSOK health plan and another plan with BCBSOK or one of the plans listed above.

Note: The standard guideline for timely filing with Coordination of Benefits is as follows and will not be changing with the retirement of the ‘Blue on Blue' process:

  • Primary claim timely filing begins at date of services rendered.
  • Secondary claim timely filing begins at date of primary claim final adjudication.

What's changing with the existing process

In the new process you will:

  • First submit just the primary claim
  • You'll receive the determination on the primary claim through your normal channels detailing the primary claim adjudication
  • Submit the secondary claim with the primary claim payment information following the guides on the Electronic Claim Submission via Availity® Provider Portal section of the website.

 

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.