Our Blue Review provider newsletter is released monthly so that you and your staff have the latest news on claims and billing, federal mandates, medical policies, condition management programs, practice guidelines, formulary/drug list updates, BlueCard and educational webinars.
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- Introducing Claim Reconsideration Requests via Availity® Essentials
- Reporting On-Demand via Availity Essentials is Now Named Provider Claim Summary
- Shared decision-making aids can help guide care choices
- Keeping an Eye on Improved Provider Collaboration
- Medical Records Reminder for Out-of-Area Medicare Advantage Members
- Continuity of Care is Driven by Prompt Communication Upon Hospital Discharge
- Importance of Early and Timely Intervention for Pre- and Post-Partum Care to Help Improve Health Outcomes
- See New Enhancements for Behavioral Health Pre-service Reviews
- Pharmacy Program Quarterly Update Changes Effective October 1, 2023 – Part 1
- Submitting Claims for Infertility Services
- BlueApprovR aims to improve patient care and provider response times
- What Do Blue Cross and Blue Shield of Oklahoma (BCBSOK) Members Want from their Health Care Professionals? Part 1
- Physician Performance Insight Reports are Now Available
- Webinar on Coding for Morbid and Severe Obesity
- Medicare Providers May Treat Medicare Advantage Flex and Group Medicare Advantage Open Access PPO Members
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2023
- Prior Authorization Codes Updated for Commercial Members, Effective Oct. 1, 2023
- Current Procedural Terminology® (CPT®) Codes Updated for Prior Authorization for Medicare, Oct. 1
- Claim Editing Changes for Professional Emergency Department Services Coming Nov. 1, 2023
- In-Home Test Kits for Colorectal Cancer Screening
- Helpful Tips: Utilizing the Carelon Provider Portal
- Statin Therapy for Patients with Cardiovascular Disease and Diabetes
- Catch Up on Routine Vaccines and Well-Child Visits
- New Availity Eligibility & Benefits Experience
- Preparing for 2023 Summer HEDIS® Medical Record Collection
- Provider Rights and Responsibilities
- Member Rights and Responsibilities
- Webinars on Cross-Cultural Care Offer Continuing Education Credit
- Coverage for Telemedicine Services since the Public Health Emergency Ended May 11
- PEAQSM Provider Performance Insights (PPIs)
- Medicare Advantage Annual Wellness Visit: Resources
- Medical Records Reminder for Out-of-Area Medicare Advantage Members
- BlueApprovRSM Expedites Medical, Surgical, Pharmacy, Behavioral Health Prior Authorization — Attend a Training
- Members can now access network of pharmacies at accredited cystic fibrosis treatment centers
- ClaimsXten™ Quarterly Update Effective August 21, 2023, New Software Version Coming
- Helping Our Members Manage Diabetes
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2023
- Current Procedural Terminology® (CPT) Codes Updated for Prior Authorization for Medicare, July 1
- Prior Authorization Codes Updated for Commercial Members, Effective July 1
- What You Need to Know about the Health Information Exchange
- BlueApprovRSM Expedites Medical, Surgical, Pharmacy, Behavioral Health Prior Authorization — Attend a Training
- Prior Authorization Codes Updated for Commercial Members, Effective July 1, also watch for Medical Oncology Portal Enhancements
- Current Procedural Terminology® (CPT®) Codes Updated for Prior Authorization for Medicare, July 1
- Behavioral Health Consultations During Hospitalization Can Improve Outcomes
- Track Care Visits During and After Pregnancy
- Health Insurance for American Indians and Alaska Natives
- Pharmacy Program Quarterly Update — Changes Effective April 1, 2023 — Part 2
- AIM Specialty Health Changes Its Name to Carelon Medical Benefits Management
- New for 2023: Specialty Pharmacies Added In-Network
- Prenatal and Postpartum Depression Screening and Follow-Up
- Follow-Up Care for Children Prescribed ADHD Medication
- Initiation and Engagement of Substance Use Disorder Treatment and Follow-up after Emergency Department Visit for Substance Use
- Earn Continuing Education Credit through Webinar on Opioids
- Pharmacy Program Quarterly Update, Part 2: Changes Effective Jan. 1, 2023
- CPT Category II Codes Can Help Close Care Gaps
- BlueApprovRSM Expedites some Prior Authorizations — Attend a Training Soon to Learn More
- Cultural Awareness Webinars: Earn Continuing Education Credit
- Quality Care: Screening for Depression
- Closing Gaps in Colon Care
- Verify Your Directory Details Every 90 Days
- Survey to Assess Medicare Advantage Members’ Experiences
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2023 – Part 1
- Help Close Gaps in Care for Group Medicare Advantage Members
- Supporting Heart Health Equity
- Prior Authorization Codes Updated for Commercial Members, Effective April 1
- ClaimsXtenTM Quarterly Update Effective April 17, 2023
- Current Procedural Terminology® (CPT®) Codes Updated for Prior Authorization for Medicare, April 1
- Delivering Quality Care: Cervical and Breast Cancer Screenings
- Hospitals Must Provide Medicare Outpatient Observation Notice
- Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed