April 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 register for informational trainings and webinars, and to learn about CHIP participation in Central Texas, changes in therapy reimbursement, the pre-service authorization process and attending physician taxonomy numbers, plus more.

Rescheduled Implementation Date of Additional Code-auditing Software

The implementation date of the additional code-auditing software, Verscend ConVergence Point^TM has been moved to June 18, 2017.

Reminder

• PCS Paper Mailing Discontinuance Effective Date Delayed; Reporting On-Demand Available

Reminder

• Medicare Outpatient Observation Notice (MOON) Requirement
  Applies to: Blue Cross Medicare Advantage (HMO)^SM and Blue Cross Medicare Advantage (PPO)^SM

CMS Requires Insurers to Conduct ACA Risk Adjustment Audit

In June, the Centers for Medicare & Medicaid Services (CMS) will begin conducting an audit to validate the data used when assessing the payment of transfers for the ACA Risk Adjustment program. BCBSTX is asking for your full cooperation if any of your patients are selected to be included in the audit.

New BCBSTX Client in Blue Essentials^SM Network: Employees Retirement System of Texas (ERS)

BCBSTX has been awarded the ERS contract, which goes into effect on Sept. 1. Find out how to contract with the Blue Essentials network.

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A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association

1001 E. Lookout Drive, Richardson, TX 75082

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