Sept. 24, 2025
Effective Jan. 1, 2026, we will expand our laboratory claims review program for routine outpatient laboratory services provided to more of our commercial members.
Beginning Jan. 1, 2026, our Administrative Services Only members will be eligible for review of:
- Outpatient laboratory claims with dates of service beginning Jan. 1, 2026
- Claims for services performed in an outpatient setting (typically office, hospital outpatient or independent laboratory)
- Any claims that meet criteria relevant to one or more of the applicable laboratory services
To accompany this expansion, beginning Jan. 1, 2026, we will implement reimbursement policies for routine laboratory services, tests and procedures for certain ASO members. View our Laboratory Management Clinical Payment and Coding Policies.
Estimate Coverage for Your Lab Claims with Avalon
Avalon Healthcare Solution’s Trial Claim Advice Tool can give you an estimate of how your lab claim may be reviewed based on the input of procedure and diagnoses codes.
Available at no cost via Availity® Essentials, the self-service tool uses information entered for the date of service and historical claims finalized through the previous business day. Claims not yet finalized won’t be included.
To access the Trial Claim Advice Tool:
- Log in to Availity Essentials.
- Select Payer Spaces from the main navigation menu and choose BCBSOK.
- Within BCBSOK-branded Payer Spaces, select Avalon under the Applications tab.
- You will be redirected to the Trial Claim Advice Tool.
This program doesn’t apply at this time to government programs.
Avalon Healthcare Solutions is an independent company that provides claims management services for members with coverage through Blue Cross and Blue Shield of Oklahoma. BCBSOK makes no endorsement, representations or warranties regarding any products or services regarding third party vendors and the products and services they offer.