Blue Review
A newsletter for Medicaid providers

May 2018

Hot Topics

HHSC’s MEDsys Contract Expires Nov. 6, 2018

The Health and Human Services Commission’s (HHSC) contract with MEDsys will expire Nov. 6, 2018, and will not be renewed. Learn what HHSC is doing to minimize the impact on providers during the transition from MEDsys to Datalogic.

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Focus on Behavioral Health

May Is Mental Health Awareness Month; Access Behavioral Health Toolkit and Other Resources

Early engagement and interventions are crucial for improved mental health outcomes. As such, access the Magellan Healthcare® Behavioral Health Toolkit for the information to make behavioral health referrals and assessments.

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Video Series: Blue PromiseSM – Depression and Chronic Conditions

Making The Health Care System Work Depression can impact chronic diseases and other medical conditions in many ways. In this Blue Promise video, Blue Cross and Blue Shield of Texas (BCBSTX) president, Dr. Dan McCoy, talks with Dr. Conway McDanald, BCBSTX’s chief medical officer and vice president of Behavioral Health, about how mental health can impact overall health.

Featured Tip

How to Keep the Cash Flowing: Home Health Provider Claim Submission Tips

Welcome to our new series of articles on ways to get paid quickly and efficiently. Topics will focus on how to prevent delayed payments such as: keeping your information updated, reducing inaccurate claim submissions, and submitting claims and repeals on time. The first article in this series focuses on preventing claim delays for home health providers.

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Network Participation

Watch for New CVO Details to Reduce Credentialing Burdens

All Medicaid-contracted professional and facility providers will begin receiving notifications from Aperture® – a Centralized Verification Organization (CVO) – regarding credentialing events and information about the new common recredentialing date that will be assigned.

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Education & Reference

Tackling Prescribing Patters to Combat the Opioid Crisis

Making The Health Care System WorkIs there a way to keep opioids out of the hands of those who don’t legitimately need them? Check out the Tackling Prescribing Patterns to Combat the Opioid Crisis article on our Making the Health Care System WorkSM news portal.

FDA-approved Indications and Dosage for Opioid Extended Release (ER) Quantity Limit Criteria

For information on how BCBSTX and providers can help members who are suffering from opioid addiction, review the Indications for Opioids ER Quantity Limit Criteria. This document summarizes the FDA-approved information released on April 1, 2018.

Well-child Visits Are Crucial During the First 15 Months of Life

Outreach is important to ensure your patients are scheduling and attending their well-child visits. Because it’s such a critical developmental time, a patient should attend at least six well-child visits during their first 15 months of life.

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Texas Health Steps: Anticipatory Guidance

Giving anticipatory guidance during well-child visits provides ongoing education about a patient’s health, wellness, growth and development in between well visits. Your involvement in member education promotes disease prevention and increases health literacy.

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TMHP Seeks CHIP Providers to Test New Eligibility System

The Texas Medicaid & Healthcare Partnership (TMHP) is seeking Children’s Health Insurance Program (CHIP) providers who are interested in testing a new system that allows providers to request and receive CHIP member eligibility. Providers should contact TMHP directly if they would like to participate or have questions.

Consumer Directed Services (CDS) Handbook Expense Updates

Appendix XI of the CDS handbook has been updated. Equipment must be employer/employment related to be eligible for reimbursement (e.g., internet service, fax machine, printer, phone or computer needed to complete employer/employment-related duties). Get more details about this change. Direct your questions to CDS@hhsc.state.tx.us.

Health & Wellness

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: 1-877-249-5777 (toll-free)

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.