November 2016

Upcoming Provider Trainings

We invite you to participate in upcoming STAR Kids provider trainings. Our trainings provide information and resources to fully engage our provider community with STAR Kids. The training schedule is below, and we ask that you RSVP by the deadline.

New! If you’re not able to attend any of the trainings below, the STAR Kids Provider Training is available for completion via Brainshark – at your own pace, date and time.

STAR Kids Provider Training – Webinar
Nov. 4, 2016
10 a.m. – 11:30 a.m.
RSVP deadline: Nov. 3 by noon

RSVP

STAR Kids Long-term Services & Support/Electronic Visit Verification – Webinar
Nov. 9, 2016
1 p.m. – 2:30 p.m.
RSVP deadline: Nov. 8 by noon

RSVP

STAR Kids Provider Training – Webinar
Nov. 10, 2016
11 a.m. – 12:30 p.m.
RSVP deadline: Nov. 9 by noon

RSVP

72-hour Emergency Prescription Supply

A 72-hour emergency supply of a prescribed drug must be provided when a medication is needed without delay and prior authorization (PA) is not available. This applies to all drugs requiring PA, either because they are non-preferred drugs on the Preferred Drug List or because they are subject to clinical edits.

Medical Transportation Services

For BCBSTX Medicaid members, two options are available for non-emergency medical transportation. Contact information is provided.

Flu Vaccination

Flu vaccinations are available for the Blue Cross and Blue Shield of Texas Medicaid program at network pharmacies. Access a list of available flu vaccines.

Texas Health Steps: Immunization Education

In addition to the importance of getting a patient’s medical history and performing an unclothed physical exam, immunization status is another important element for Texas Health Steps and well-child exams.

Texas Health Steps: Missed Appointments

The Texas Health Steps Provider Outreach Referral form should be used by all Texas Health Steps (THSteps) providers who submit a referral on behalf of a THSteps patient who needs assistance with scheduling a follow-up appointment, rescheduling a missed appointment, scheduling transportation to an appointment or other outreach services.

Children of Migrant Farmworkers

Children of migrant farmworkers who are due for a Texas Health Steps medical checkup can receive their periodic checkup on an accelerated basis prior to leaving the area. A checkup performed under this circumstance is an accelerated service, but should be billed as a checkup. Performing a make-up exam for a late Texas Health Steps medical checkup previously missed under the periodicity schedule is not considered an exception to periodicity, nor an accelerated service. It is considered a late checkup.

Engaging with Our Members Now and for the Future

Review results from the 2016 member experiences survey. Results, access-to-care discussion questions, and tips for engaging patients are provided.

Hello, Hola, Bonjour, Ciao!

Working to improve the language barrier between you and your patients improves health outcomes. Helping Spanish-speaking patients understand their health care situation and options helps them make educated and informed decisions for their children and themselves. As such, learn about a state requirement that says your after-hours messaging and/or answering services must provide Spanish language service.

Reminder: Synagis Season Is Here

Respiratory Syncytial Virus (RSV) season is here. For the 2016-17 season, BCBSTX Medicaid and CHIP will be following the schedule recommendations of the Texas Pediatric Society (TPS) Infectious Disease Committee/RSV Task Group, which are the 2014 American Academy of Pediatrics (AAP) recommendations. The Task Group has reviewed more than 10 years of epidemiologic data and recommends the period for prophylaxis in the Travis Service Area to be from Oct. 15, 2016, to March 31, 2017, using the 2014 AAP recommendations. As we will allow a maximum of five injections of Synagis during the season, it is important to be aware of the current epidemiology. The TPS information and epidemiologic updates are available on the TPS website.

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

Provider Customer Service: 877-560-8055, Monday - Friday, 8 a.m. - 8 p.m. CT

For general questions and concerns, contact the BCBSTX Medicaid Provider Network Management department:
Email: TexasMedicaidNetworkDepartment@bcbstx.com
Phone: 855-212-1615
Fax: 512-349-4848

For member outreach inquiries, BCBSTX Medicaid (STAR) and CHIP members may contact Sonia Saenz, Senior Outreach Specialist/Member Advocate, sonia_saenz@bcbstx.com, 512-349-4883. If the member is unable to reach Sonia, please contact Consuelo Izquierdo, chelo_izquierdo@bcbstx.com, 512-349-4887.

For BCBSTX Medicaid (STAR) and CHIP quality inquiries, please contact Kathleen Thompson, Manager Medicaid Quality, kathleen_M_thompson@bcbstx.com, 512-349-4836.