Availity’s Attachments tool allows providers to submit recommended clinical review (formerly predetermination) requests online to Blue Cross Blue Shield of Oklahoma (BCBSOK).
A recommended clinical review is a voluntary request for written verification of benefits prior to rendering services. BCBSOK recommends submitting a request if the service may be considered not medically necessary, as specified within the BCBSOK Medical Policy.
You must be registered with Availity to use the Attachments tool. You can sign up today at Availity, at no charge. For registration assistance, call Availity Client Services at 800-282-4548.
This information does not apply to requests for Medicare Advantage members.
How to access and submit recommended clinical review requests using Availity Attachments:
- Log in to Availity
- Select Claims & Payments from the navigation menu
- Select Attachments – New
- Within the tool, select Send Attachment
- Download, complete and save the Recommended Clinical Review Request Form
- Complete the required data elements
- Upload the completed form and attach supporting documentation
- Select Send Attachment(s)
For additional details, refer to the Recommended Clinical Review User Guide.
Questions?
Email our Provider Education Consultants. Be sure to include your name, direct contact information, Tax ID and/or billing National Provider Identifier (NPI).
Please note that the fact that a service has been prior authorized/pre-notified, that a guideline is available for any given treatment or that a service or treatment has been recommended clinical review 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 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. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.