When an active member goes to an in-network provider, the provider submits the claim to the local BC/BS office that they would submit any BC/BS claim to. If an active member goes to an out-of-network provider, the provider will, in most cases, also submit the claim to the local BC/BS office. If not, then the member can submit the bill to INDECS for adjudication.

When a Medicare eligible member goes to a provider, the provider will submit the claim to Medicare and, in most cases, will submit the balance to the secondary carrier (OU Health Plan). If not, the member can submit the balance bill, along with the Coordination of Benefits (COB) from Medicare, to INDECS for adjudication.