Provider Webinars Scheduled for 2018


Blue Review

A newsletter for physician, professional, facility, ancillary and Medicaid providers

January 2018


Monthly News for Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid (STAR), STAR Kids & CHIP Providers

Read this month’s Medicaid newsletter to learn about reimbursements for CHIP services, THSteps procedures and documentation, private duty nursing policy clarification, free value-added services and more.

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Notices & Announcements

Provider Webinars Scheduled for 2018

Billers, utilization areas and administrative departments should attend the upcoming 2018 complimentary educational webinars. Topics include: AvailityTM 101, iExchange® and remittance viewer.

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Update to the Durable Medical Equipment/Prosthetics and Orthotics Fee Schedule, Effective Dec. 1, 2017

Review the updates made to the Durable Med Equipment/Prosthetics & Orthotics fee schedule.

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Reminder: BlueOptionsSM Benefit Plan Design No Longer Offered Beginning Dec. 31, 2017

Since Dec. 31, 2017, the BlueOptions benefit plan product is no longer offered as a BCBSTX product. BlueOptions provided enhanced benefits to BCBSTX members who obtained care from Blue Choice PPOSM physicians who were recognized through the BlueCompareSM program for cost efficiency and quality performance. BlueCompare for Physicians, the program that measures quality for certain specialties, will continue providing performance reporting to physicians and members. Please note that the elimination of this benefit plan does not affect any other networks. If you have questions, please contact your BCBSTX Network Representative.


Claims & Eligibility


Clinical Resources

Annual Medical Record Data Collection for Quality Reporting Begins Feb. 1, 2018

HEDIS® season is upon us. A representative from BCBSTX or from our contracted vendor, CIOX, may be contacting your office between February and May to work out details for collecting medical records. Cooperation with the collection of HEDIS and QRS data are required under the providers’ contractual obligation. We appreciate your time and effort to help us meet the HEDIS requirements.

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Behavioral Health Program Changes for Boeing Members, Effective Jan. 1, 2018

BCBSTX is now administering Boeing plan members’ behavioral health benefits.

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Skilled Nursing Facility (SNF) Benefit Change for Federal Employee Plan (FEP) Members

Beginning Jan. 1, 2018, senior patients with an FEP Standard Option health plan who are not enrolled in Medicare Part A, but need rehabilitation that a nursing home does not offer, will be covered for up to 30 days per benefit year of inpatient SNF care.

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Preventive Care Guidelines Are Available

The 2017-18 Preventive Care Guidelines are available. Each year, BCBSTX reviews the recommendations made by several professional organizations to update the Preventive Care and Wellness Guidelines related to preventive care, health screenings and immunizations.

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Pharmacy Program

Pharmacy Benefit Tips

Learn strategies you can use to help our members – your patients – use prescription drugs appropriately.

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Standards & Requirements


Education & Reference



In Every Issue

BCBSTX is required to provide certain notices in all published correspondence with physicians, professional providers, and facility and ancillary providers. For the latest updates, visit the News and Updates area of the BCBSTX provider website. Access this month’s articles.

Printable PDF

View a printable PDF of the non-Medicaid information in this newsletter.

Contact Us

View our quick directory of contacts for BCBSTX.

Update Your Information

Do you need to update your location, phone number, email or other important details on file with BCBSTX? Use our online forms to request information changes.

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an Independent Licensee of the Blue Cross and Blue Shield Association

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