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Provider Tools

At Blue Cross and Blue Shield of Oklahoma (BCBSOK), we are committed to providing support to physician practices. We've designed tools that health care providers find useful. Whether doing research or streamlining billing, these tools can help you evaluate costs, save time, improve service and more.


Availity's Claim Research Tool

Availity's new online Claim Research Tool (CRT) provides your office staff greater claims accuracy and increased office efficiency in managing your account receivables. The CRT also ends the need for costly, time-consuming phone calls. Simply log into the Availity Website and follow the instructions on the CRT tip sheet . Use Availity's Claim Research Tool now .


Availity Eligibility

It is important to verify membership and check coverage details for every patient at every visit, before you administer treatment.

To obtain fast, efficient, detailed benefits information for Blue Cross and Blue Shield members, you can use Availity's Eligibility and Benefits tool. This free online tool can provide you with co-payment, co-insurance, deductible, and other important information.

Availity Eligibility and Benefits Tip Sheets

You must be registered with Availity  to gain access to this and other online resources offered by Availity.


Availity is a registered trademark of Availity, L.L.C., an independent third party vendor that is solely responsible for its products and services.

Verification of 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, any claims received during the interim period and the terms of the member's certificate of coverage applicable on the date services were rendered.


Behavioral Health Eligibility and Benefits Tip Sheet

Behavioral health professionals and physicians may obtain benefits information for Blue Cross and Blue Shield members using the Availity® Eligibility and Benefits (E&B) tool. This free online tool can provide you with copayment, coinsurance, deductible, and other important information. Learn More.


Blue Distinction®

BCBSOK, in partnership with the Blue Cross and Blue Shield Association, has developed Blue Distinction Centers. Each Center has been selected through a rigorous, evidence-based, objective selection criteria established with input from medical experts and organizations.

Blue Distinction is a nationwide program that will create an unprecedented level of healthcare transparency with two goals: engaging consumers to enable more informed healthcare decisions and collaborating with providers to improve quality outcomes and affordability.

To learn more about the program, selection criteria, and designated centers in each state, visit Blue Distinction for ProviderSM


Bridges to Excellence

BCBSOK is licensed as a sponsor of the Bridges to Excellence® (BTE) Diabetic Care Recognition program and Cardiac Care Recognition programs. Learn More.


Care Profile®

CareProfile is a user-friendly, electronic health record that assists health care professionals in making informed treatment decisions for their patients. It's available free of charge to physicians and provider organizations registered with Availity in Oklahoma. To register, visit availity.com , or call Availity Client Services at (800) AVAILITY (282-4548). Learn more about CareProfile.


CareCost EstimatorSM

The Availity® CareCost Estimator (CCE) tool is an online member liability estimator that can help professional providers estimate a patient's potential out-of-pocket costs in real-time for office and outpatient services provided to BCBSOK members. Learn more.


Claim Inquiry Resolution (CIR) Tool

The Claim Inquiry Resolution  tool can be accessed via a tab in our Electronic Refund Management (eRM) system. The CIR tool allows you to communicate online with our Customer Advocates in some situations where previously a call or letter was required. Learn more.


Clear Claim Connection

Clear Claim Connection is a Web-based code auditing reference tool that mirrors BCBSOK edits (i.e., unbundling, mutually exclusive, and incidental). Learn more.


Electronic Refund Management (ERM)

This online refund management tool will help simplify overpayment reconciliation, as well as related processes and transactions. Use the ERM tool now.


iEXCHANGE

iEXCHANGE is an automated preauthorization tool for Blue Cross and Blue Shield of Oklahoma (BCBSOK). iEXCHANGE supports direct submissions and provides online approval of benefits for inpatient admissions, referrals and select outpatient services. iEXCHANGE is accessible to network physicians, professional providers and facilities within Oklahoma 24-hours-a-day, seven-days-a-week via a Web-based application.

To request personal one-on-one training for specific education modules, please send us an email at PACS@HCSC.net and include your name, telephone number and modules of interest.