Blue Review
A Medicaid Provider Newsletter

April 2018

Hot Topics

Reminder: The HEDIS® 2018 Season Is Upon Us

Review the HEDIS HYBRID 2018 measures that are up for performance review. Also, some measures require information directly from patient medical records that are kept at the physician’s office. As such, we may contact your office with a list of patients whose medical records need to be reviewed. If your office uses a third-party vendor for medical records, please notify us immediately so steps can be taken to obtain the necessary records in a timely manner.

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Focus on Behavioral Health

Behavioral Health: Let’s Talk About It!

In the third quarter of 2017, Blue Cross and Blue Shield of Texas (BCBSTX) conducted a survey to gather feedback on the Blue Review newsletter. Many of you asked for more information about behavioral health, and we want you to know that we heard you.

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Behavioral Health Toolkits

Magellan has provided two behavioral health toolkits – one for general behavioral health and the other for postpartum depression – to help you guide patients toward appropriate care when needed.

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The Intersection of Physical and Behavioral Health Care

Making The Health Care System WorkAll of us have a vital role to play in the health care system. Making the Health Care System WorkSM is an online magazine that explores how we can make the health care system work better for everyone. Article categories include: access to care, cost drivers, health and innovation. Read the articles for yourself, recommend them to your colleagues, staff, patients, friends and family. This month, check out The Intersection of Physical and Behavioral Health Care.

Featured Tip

Accessing Provider Manuals Is Now Easier!

We’re pleased to announce that accessing the online manuals for STAR Kids and STAR/the Children’s Health Insurance Program (CHIP) just got easier. The manuals are now divided into sections, so you can easily access and print the information you need. The manuals are in PDF format and require Adobe® Reader to open and view. They are updated, as needed, and reposted to the Education and Reference section of the BCBSTX provider website.

Network Participation

Reminder: Medical Appointment Access and Availability

Primary Care Providers must have procedures in place for members who need assistance after hours.

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Education & Reference

Improving Disparities in Oral Health

Help eliminate oral health disparities by incorporating all Texas Health Steps components into your practice. Spend time educating your patients about the importance of daily dental hygiene.

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Health & Wellness

New! Health Tips to Share

Help your patients live a healthier life by sharing relevant wellness information with them. You can print individual articles, or point your patients to the websites so they can review topics that interest them. Anyone can access the websites; no login required.

LifeTimesBCBSTX’s LifeTimes website has many articles on a range of topics including: bone and joint health, cancer, diabetes, general health, and heart and lung health. Spanish content is available.

ConnectConnect invites users to get answers, share information and gain knowledge on topics like well-being and health coverage through blogs, videos and downloadable content. Participants can create a profile and like posts, add their opinions in the comments and subscribe to content they’re interested in. Spanish content is available.

Webinars

If you are a newly contracted provider or an existing provider who needs a refresher on topics related to Texas Medicaid, please consider attending one of our weekly webinars.

Provider training with the Texas Medicaid Network Department will occur every Friday from 12:30 – 2 p.m. CT. The topics for these trainings will vary and meeting details will be updated and posted on BCBSTX’s Medicaid provider website.

Request Meeting Topics!
Please email the Texas Medicaid Network Department to request training topics!

Meeting Information
Join the WebEx meeting: hcsc.webex.com
Meeting number: 626 749 977

Join by phone:
Toll-free: 1-877-249-5777

If you are unable to attend our training sessions, they are available for completion via Brainshark® at your own pace, date and time.

Have You Updated Your Provider Information?

Visit the BCBSTX provider website to update any changes to your address, telephone number, group affiliation, and/or any other material facts via the Provider Data Update Notification form. Also, update your information with Texas Medicaid & Healthcare Partnership via their Provider Information Change form.

News & Updates

For the most up-to-date information, view the News & Updates section of the BCBSTX provider website.

Link to BCBSTX Medicaid Website

On this website, you will find links to the provider manual, Quick Reference Guide, services requiring prior authorization and other useful information.

Contact Us

Eligibility, Benefits, Provider Network Referrals and Claim Status
Medicaid (STAR) and CHIP Customer Service: 1-877-560-8055, Monday - Friday, 8 a.m. - 8 p.m. CT
STAR Kids Customer Service: 1-877-784-6802, Monday - Friday, 8 a.m. - 8 p.m. CT

For general questions and concerns:
Email: TexasMedicaidNetworkDepartment@bcbstx.com
Phone: 1-855-212-1615
Fax: 1-512-349-4848

For member outreach inquiries, BCBSTX’s Medicaid (STAR), STAR Kids and CHIP members may contact Zenaida Martinez Nava, Senior Outreach Specialist/Member Advocate at 1-512-349-4880. If the member is unable to reach Sonia, please contact Maria Izquierdo at 1-512-349-4887.

For BCBSTX Medicaid (STAR), STAR Kids and CHIP quality inquiries, please contact Kathleen Thompson, Manager Medicaid Quality, at 1-512-349-4836.

For Electronic Visit Verification questions, please email BCBSTX_EVV_Questions@bcbstx.com.