April 12, 2022
We will be making changes to how misdirected claims are handled for Federal Employee Program (FEP) members.
Claims for FEP members should be filed with the Local Plan where services were rendered (the physical location where the provider is located).
Currently, some FEP claims are mistakenly submitted to the Plan where the member resides rather than to the Local Plan. In these cases, Blue Cross and Blue Shield of Oklahoma (BCBSOK) has manually forwarded the claims to the Local Plan.
Effective June 15, 2022, BCBSOK will no longer forward misdirected claims for FEP members to the Local Plans for processing: Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Illinois and Blue Cross and Blue Shield of Texas. Instead, we will deny these and instruct you to resubmit the claims to the appropriate Local Plan where the service was rendered.
For example: If an FEP member resides in Virginia, but received services in Oklahoma, the claim should be filed in Oklahoma.
Similarly, if you treat FEP members from any of these four out-of-state Plans, and you submit the claims to the member’s Plan rather than BCBSOK, your claim will be denied, and you’ll be instructed to resubmit your claim to us, the Local plan where services were rendered.