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BCBSOK Preauthorization Changes Beginning Jan. 1, 2019

November 1, 2018

Effective Jan. 1, 2019, Blue Cross and Blue Shield of Oklahoma (BCBSOK) will be updating some preauthorization requirements.

Patient eligibility and benefits should be verified prior to every scheduled appointment.

Eligibility and benefit information includes membership verification, coverage status and, preauthorization requirements. To obtain fast, efficient, detailed information for BCBSOK members, please access the Availity® Eligibility and Benefits tool located at https://www.availity.com/resources/support/provider-portal-registration Learn more about third-party links. Please note that you must be registered with Availity® to gain access to this free online tool.

Watch for updates to the Preauthorization Requirements list reflecting the 2019 changes. These will be posted on the BCBSOK provider website at https://www.bcbsok.com/provider on the Clinical Resources page/Prior Authorization.

Additional tip sheets are available on the BCBSOK Provider website under Education and Reference Center.

If you have any further questions, contact your Provider Network Representative.

Please continue to watch for further information on the BCBSOK website and the Blue Review provider newsletter.

Please note that verification of eligibility and benefits, and/or the fact that a service or treatment has been preauthorized or predetermined for benefits 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, contact BCBSOK Provider Customer Service at (800) 451-0287.

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. Aerial, iExchange and Medecision® are trademarks of Medecision, Inc., a separate company that offers collaborative health care management solutions for payers and providers. BCBSOK makes no endorsement, representations or warranties regarding any products or services offered by Availity or Medecision. The vendors are solely responsible for the products or services they offer. If you have any questions regarding any of the products or services they offer, you should contact the vendor(s) directly.