Benefit Information Accessible in the IVR Phone System
As a reminder, on Dec. 12, 2016, Customer Advocate assistance was removed for several common benefit categories within the Interactive Voice Response (IVR) phone system since the IVR quotes the same level of member eligibility and benefits information as a Customer Advocate would provide. Rest assured that our Advocates will continue to be available for more complex benefit quotes.
Blue Cross and Blue Shield of Oklahoma (BCBSOK) is committed to providing efficient and secure access to member information. To assist with the recent IVR change, we have included the benefit categories that are currently contained in the IVR. This listing is continually reviewed and may vary across our different BCBSOK networks, products and/or group policies. There is a separate category containment list below for Federal Employee Program (FEP) members.
IVR Contained Benefit Categories
|Office Visit||Hospital||Preventive Care|
|Coordinated Home Care||Laboratory||X-ray|
|Extended Care Facility||Mammogram||EKG|
|Physical Exam||Inhalation Therapy||Consultations|
|Pap Smear||Private Duty Nursing||Office Services|
FEP IVR Contained Benefit Categories
|Chiropractic Services||Outpatient Physical, Occupational and Speech Therapy|
|Diagnostic – Lab, X-ray, Outpatient Diagnostic||Vision|
|Inpatient Benefits – Inpatient Hospital, Inpatient Surgery|
When navigating the IVR to determine patient coverage or connecting with a Customer Advocate to request pre-determination of benefits status, it is imperative that you select the exact benefit category that will be rendered for the member. This will ensure that you receive the most accurate benefit information associated with your request.
Checking eligibility and benefits electronically through AvailityTM or your preferred web vendor is the quickest way to access information for BCBSOK members. To learn more about online solutions, refer to the Provider Tools section under our Education and Reference Center. For IVR navigational assistance, refer to the Eligibility and Benefit Caller Guide found on our provider website at bcbsok.com/provider.
For out-of-state Blue Cross and Blue Shield members, who cannot verify BlueCard® Eligibility and Benefits online call the BlueCard Eligibility Line at 800-676-BLUE (2583) for verifications. Learn more about Blue Card.
For Federal Employee Program (FEP) members, eligibility and benefits can be obtained electronically or by calling 800-722-3130.
Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member's eligibility and the terms of the member's certificate of coverage applicable on the date services were rendered. If you have questions, please call the number on the member's ID card.
Availity is a trademark of Availity, L.L.C., 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 offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.