September 2017

Medicaid

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 mandatory training for FMSAs, HEDIS audit season, TMHP enrollment requirements, and more.

Your Feedback Is Important

Blue Review strives to offer important information each month to our contracted providers. To deliver the content that’s most relevant to you and all staff, BCBSTX needs your feedback. Please take a few minutes to complete our brief survey. As a thank you for your time, we’re providing an opportunity to win one of five, $25 Amazon.com^® gift certificates. (Note: government employees are not eligible.)

Integration of Prime Therapeutics^® and Walgreens^® Specialty Pharmacy and Mail Order Services

Prime Therapeutics and Walgreens created a specialty pharmacy and mail order services company. As of mid-August, all BCBSTX members whose pharmacy benefits are administrated through Prime will have been integrated into the new combined company’s pharmacy systems. Review a summary of the changes you might experience due to this integration.

Reminders

• BCBSTX New Employer Group Plan - Employees Retirement System of Texas Effective Sept. 1, 2017
• Become a BCBSTX HealthSelect^SM of Texas Provider Today
• Fee Schedule Updates Effective Oct. 1

Changes to Billing and Documentation Information and Requirements

Policy changes related to billing and documentation requirements are going into effect Sept. 15, including permissible, pass-through, under-arrangement and all-inclusive billing, and more.

New ClaimsXten^TM Rules to Be Implemented Soon

Be sure you’re familiar with the four new rules that will be implemented for ClaimsXten beginning Sept. 18.

Reminders

• New EFT and ERA Information Available Online
• All Providers to Begin Receiving EFT and ERA Files

Video: TMA PracticeEdge – A Year in Review

Watch this video that looks back at the first year of Texas Medical Association (TMA) PracticeEdge, LLC – a joint venture between BCBSTX and the TMA, which has helped Texas maintain a strong base of independent physicians in high-functioning practices. Dr. Dan McCoy, President of BCBSTX, interviews an employee to gain insights into the program. You can view this and other videos on the Blue Promise^SM blog, which aims to address complicated health issues with candid conversations from subject matter experts.

Where Data Flows, Improvements Are Bound to Follow

Learn about BCBSTX’s multi-pronged, multi-year effort to put quality, provider performance and member clinical data within easy reach of providers electronically, 24/7.

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