Nov. 1, 2024
We’re changing prior authorization requirements for Medicare Advantage members to reflect new, replaced or removed codes. Changes are based on utilization management or American Medical Association updates. Changes include:
- Jan. 1, 2025 – Removal of medical oncology and supportive care codes previously reviewed by eviCore healthcare
- Jan. 1, 2025 – Medical oncology drug codes previously reviewed by eviCore to be reviewed by Blue Cross and Blue Shield of Oklahoma
For a complete and up-to-date list of codes, refer to prior authorization lists.
Always check eligibility and benefits first through Availity® Essentials or your preferred vendor prior to rendering services. This step will confirm prior authorization requirements and utilization management vendors, if applicable.
Checking eligibility and/or benefit information and/or obtaining prior authorization 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, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK. eviCore healthcare is an independent specialty medical benefits management company that provides utilization management services for BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.