As a newly contracted BCBSOK physician or other professional provider (or a new employee of a contracted provider's office) we encourage you to take advantage of the reference materials available to you online:
- Electronic tools, such as online eligibility and benefit verification and billing, and
- The Blue Review — BCBSOK's provider newsletter. To receive the monthly Blue Review provider newsletter please fill out the online form: Receive Newsletter by email.
We are presenting this information electronically to better serve the needs of you and your staff. If you have any questions, please contact your Provider Network Representative.
Stay in Touch
- Have other questions? Visit our Contact Us page.
- Provider Contact Reference Guide
Claims and Eligibility
- To get started providing services to our members, visit our Claims and Eligibility section. Here you will find sample member identification cards , information about electronic commerce options, learn how to verify patient eligibility and benefits online, and information on submitting claims.
- And to help you understand the information you will receive from BCBSOK, review the Provider Claims Summary guide.
- Learn more about predetermination and precertification in our Utilization Management section. You can also find a writable PDF version of the predetermination request online.
- For claim reviews, refer to your provider contract or ask your Provider Network Representative. To submit a request, use the online forms found on the Forms page of our website.
- For a copy of your fee schedule, contact your Provider Network Representative. Professional providers participating with BCBSOK may use the Fee Schedule Listing tool on the Availity® Provider Portal to submit electronic requests and receive the contracted price allowance for specific codes.
Education and Reference
- As a participating provider with BCBSOK, this link will inform you of our Subscribers’/Members’ Rights and Responsibilities. Your patients may access this information in their benefit booklet.
- You have certain rights and responsibilities that may affect your practice as a participating provider in BCBSOK provider networks.
- Find the latest information that is important to you in our News and Update section.
- Descriptions and links to useful resources can be found on our Tools page.
- Find useful digital versions of frequently used forms, including claims related forms such as the OK Claim Review (Claim Appeal/Reconsideration Review Request) and Provider Refund form. For more information on appeals, refer to your provider contract or ask your Provider Network Representative.
Pharmacy
- To see the latest Formulary information and drug lists, view our Pharmacy section.
- View the latest NDC Billing guidelines in the Pharmacy section.
- To receive updates about Prime Drugs and Generics, sign up for Prime Pipeline newsletter
specialty pharmacy drug lists and a Prime Specialty Fax form can be found in the Specialty Pharmacy section.
Additional Resources
- Learn about the responsibilities of BCBSOK, providers and our standards of care on the Quality Improvement page.
- A list of Medical Policies Web Accessibility Initiative and Draft Medical Policies