Continuity of Care During COVID-19 Outbreak
This global pandemic has restricted travel in many circumstances and lessened the desire for some to travel out of state on their own to continue receiving specialized health care treatments. In order to make it easier for Blue Cross and Blue Shield of Oklahoma (BCBSOK) members to continue these important, and in many cases life-saving, treatments, BCBSOK will authorize any member who was receiving treatment outside of Oklahoma prior to March 15 to continue receiving care by transitioning to an in-network provider in the state or we will cover the costs of seeing an out-of-network provider in Oklahoma at the in-network rate.
For BCBSOK to honor this exception, out-of-network providers must agree to the following requirements:
- Accept the median in-network rate for the member’s network under their plan;
- Adhere to BCBSOK’s medical policies and authorization requirements;
- Accept in-network reimbursement allowance as payment-in-full less any deductible, coinsurance or copayments owed by the member to protect against surprise or balance billing for services and/or treatments rendered.
If all requirements are met, BCBSOK will reimburse the out-of-network provider directly for covered services. This special coverage period to assist with in-state, out-of-network treatment will continue through Oct. 31, 2020 (Previously Aug. 31). As the Aug. 31 date approaches, the timeframe may be extended depending upon the status of the COVID-19 situation and ability for people to safely travel and resume care with their out-of-state providers.
This special coverage exception applies to BCBSOK fully insured PPO members, but we will share the agreements reached with local, out-of-network providers with ASO customers and other Blues Plans so they have the opportunity to participate and offer similar solutions to their members.