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Extending Prior Authorization on Previously-Approved Elective Surgeries, Procedures and Therapies

April 9, 2020
Update: May 11, 2020

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is temporarily extending approvals on services with existing prior authorizations until Dec. 31, 2020. This applies to services that were originally approved or scheduled between Jan. 1 and June 30, 2020 (previously April 1, 2020). This is for most non-emergent, elective surgeries, procedures, therapies, home visits and behavioral health services.

A member may reschedule an approved procedure to a later date in 2020 without a new prior authorization. This applies only to active members for a benefit that is covered under their plan at the time services are rendered.

We will continue to monitor the national health emergency and will update as appropriate.

Details

  • BCBSOK will honor all BCBSOK prior authorizations on non-emergent surgeries, procedures, therapies, home visits and behavioral health services approved or scheduled between Jan. 1, 2020, and June 30, 2020 (previously April 1, 2020).
  • These prior authorizations will remain approved through Dec. 31, 2020. Approved services can be rescheduled with the authorized provider any time before Dec. 31, 2020, based on provider availability.
  • Therapy sessions and home visits authorized for a specific number of occurrences between Jan. 1, 2020, and June 30, 2020 (previously April 1, 2020), will have the same number of occurrences available to an eligible member through the end of the year.
  • These rules apply to current members for a benefit that is currently covered under their plan.

Is this for all members?
This is for all group, fully-insured, retail, self-funded, and Medicare Advantage members.

What you need to do
You do not need to do anything to extend an authorization; it will be automatically extended.

Please notify us when services subject to a prior authorization are rendered. For inpatient admissions, let us know when one of our members is admitted to your facility.

Excluded prior authorizations
Prior authorizations for specialty medications are not extended. You must submit a new request for specialty medications.

Additional services or sessions
If a member seeks additional services or sessions, you must submit a new prior authorization request to BCBSOK for those additional services or sessions.