We invite you to participate in upcoming STAR Kids provider training Webinar. Our trainings webinars provide information and resources to fully engage our provider community with STAR Kids. The webinar 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 Dec. 6, 2016
Noon – 1:30 p.m. RSVP deadline: Dec. 2 by 5 p.m.
Learn about the new claims submission edits that went into effect on Nov. 1 for Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid CHIP, STAR and STAR Kids programs. Necessary information is needed on electronic claim submissions in order to comply with the state's Medicaid data reporting requirements.
Reminder: Taxonomy Numbers Are Now Required on All Claim Submissions
This is a reminder about the new taxonomy number requirements for the CMS-1500 and UB-04 forms. Our mailing, and complaints and appeals addresses are included.
Provider agencies required to use a Health and Human Services Commission (HHSC)-approved Electronic Visit Verification system must have begun using the revised and new reason codes beginning Dec. 1, 2016. Failure to use the revised and new reason codes may result in claim denial, recoupment or contract action. Read the full announcement.
Effective Jan. 1, 2017 – Notification for Post-stabilization Care Following an Emergency Admission Is Required
For stabilized members, BCBSTX requires notification of admission for post-stabilization care services within one business day following treatment of an emergency medical condition.
Appointment availability and after-hours access are an aspect of patient care that providers, nursing staff and front office staff need to be aware of. Review the state-mandated timeframes for access and availability standards.
Texas Health Steps: The Importance of Developmental Surveillance and Mental Health Assessments
We are providing the validated and standardized tools that THSteps recommends when performing developmental screenings. According to the Texas Health and Human Services Commission, developmental surveillance or screenings must be performed at each checkup for patients’ ages birth through 6 years.
Ideas for Talking to Your Patients with Attention Deficit Hyperactivity Disorder (ADHD)
Approximately 6.4 million children were diagnosed with ADHD as of 2011. Review a list of ideas to help you talk with your patients and their families about the disorder.
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 .
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 (TMHP) 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.
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_thompson@bcbstx.com, 512-349-4836.
