Blue Review
A Medicaid Provider Newsletter

January 2017

Claims Submissions – Options and Information

Participating physicians, professional providers and facility providers are requested to submit claims electronically to Blue Cross and Blue Shield of Texas (BCBSTX) within 95 days of the date of service, or by using the standard CMS-1500 or UB04 claim form.

BCBSTX Medicaid STAR, CHIP, CHIP Perinate and STAR Kids Alpha Prefixes

  • Medicaid (STAR) – ZGT
  • CHIP – ZGC
  • CHIP Perinate – ZGE
  • STAR Kids – WZG

Electronic Claims Submissions

  • Payor ID – 66001
  • Alpha prefix + 9 digit Medicaid/CHIP ID (e.g., ZGC12345789)

Paper Claims Submissions

  • Claims mailing address:
    Blue Cross and Blue Shield of Texas
    P.O. Box 51422
    Amarillo, TX 79159-1422

Appeals
Submit appeals within 120 calendar days from receipt of remittance advice (RA) using one of the following methods.

Mail

  • Attach the Provider Appeal Request form
  • Appeals address:
    Blue Cross and Blue Shield of Texas
    Attn: Complaints and Appeals Department
    P.O. Box 27838
    Albuquerque, NM 87125-7838

Fax
855-235-1055

Email
GPDTXMedicaidAG@bcbsnm.com