Blue Review Provider Newsletter

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.

To receive the Blue Review provider newsletter please click on the Receive newsletter by email link under Related Resources or fill out the Change Existing Demographic Information form and include your email.

March 2024

  • The Importance of Updating Provider Demographics
  • Medicare Advantage HEDIS Records Collection through June 2024
  • Federal Employee Program® Updates to Prior Approval Requirements and Benefits
  • Closing Gaps in Colon Care
  • Pharmacy Program Quarterly Update Changes Effective April 1, 2024 – Part 1
  • Follow-up Care for Mental Health
  • Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
  • Reminder: Update Your Records with New Mailing Address for Paper Commercial Claims and Inquiries
  • Use the National Drug Codes Units Calculator Available in Availity® Essentials
  • See Our Revised Clinical Payment and Coding Policy for Anesthesia Services

February 2024

  • Blue Cross and Blue Shield Federal Employee Program® HEDIS® Records: Collecting February through April 2024
  • Managing Antidepressant Medication
  • Supporting Healthy Hearts
  • ClaimsXten™ Quarterly Update Effective April 15, 2024
  • Pharmacy Program Quarterly Update: Changes Effective Jan. 1, 2024 – Part 2
  • Coding Webinars: Major Depressive Disorder and Annual Wellness Visits
  • Changes to Claim Inquiry Resolution – High-Dollar, Pre-Pay Reviews Only

January 2024

  • Reminder: Update Your Records with New Mailing Address for Paper Commercial Claims and Inquiries
  • Update Your Records: New Medicare Open Access PPO Members and ID Cards
  • Prior Authorization Codes Updated for Commercial Members
  • Prior Authorization code updates for Medicare Advantage
  • Blue Cross and Blue Shield of Oklahoma began issuing direct payment to out-of-network providers, effective Nov. 1, 2023
  • Three New ClaimsXten™ Rules to be Implemented March 2024
  • Oral Oncology Pharmacy Network Transitioned to IntegratedRx™
  • Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2024 – Part 1
  • Monitoring Children Using ADHD Medication
  • Remind Our Members about Cervical and Breast Cancer Screenings
  • BCBSOK’s Approach to Managing GLP-1 Agonist Medications
  • Centers for Medicare and Medicaid Services Guidelines for Availability and Access Standards to Care for Medicare Advantage Members
  • Hospitals Must Provide Medicare Outpatient Observation Notice
  • Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
  • Appropriate Use of Opioids Program to be Retired January 2024
  • Utilization Management: How to Avoid Delays and Denied Claims
  • Annual Medical Record Data Collection for HEDIS Quality Reporting begins Feb. 1

 

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