March 2017

Upcoming Provider Training Webinars

You are invited to participate in upcoming provider training webinars. Our webinars provide information and resources to fully engage our provider community. The webinar schedule is below, and we ask that you RSVP by the deadline.

Note: If you’re not able to attend any of the trainings below, they are available for completion via Brainshark – at your own pace, date and time.

Changes in Therapy Reimbursement

Blue Cross and Blue Shield of Texas (BCBSTX) is delaying application of therapy rate reductions to avoid retroactive recoveries, but will implement the rate change on April 1, 2017, effective for STAR, STAR Kids and CHIP.

Changes in Prior Authorization Process Effective June 1, 2017

Beginning June 1, eviCore^TM healthcare will provide prior authorization for expanded outpatient and specialty utilization management for BCBSTX Medicaid members. Review the list of specialized clinical services eviCore will manage.

Network Participation

BCBSTX is extending the opportunity to participate as a CHIP provider in the Medicaid rural service area of Central Texas. To find out more information about program participation, contact the Texas Medicaid Network Department at 512-349-4865.

After-hours Access and Language Services Requirements

As a reminder, contracting with BCBSTX requires certain after-hours access and language component for our shared members/patients. Please check your phones to ensure the after-hours Spanish language component is available.

Tuberculosis Screening: An Important Component of THSteps

Tuberculosis (TB) screenings are another important component of THStep. Learn about the requirements for TB screenings, such as the annual questionnaire and the Tuberculin Skin Test.

Free Online Continuing Education Courses from the Department of State Health Services

THSteps’ award-winning online program offers free continuing education courses for primary care providers and other health professionals. These courses offer updated clinical, regulatory and best practice guidelines for a range of preventive health, oral health, mental health and case management topics.

Provider Outreach Referral Form

As a reminder, the THS Provider Outreach Referral form should be used by all THSteps providers who submit a referral on behalf of aTHSteps patient who needs assistance with:

• Scheduling a follow-up appointment
• Rescheduling a missed appointment
• Scheduling transportation to an appointment
• Other outreach services

March Is for Women’s Wellness

Learn what you can do to increase compliance and education regarding preventive care for women. This month we’re highlighting cervical and breast cancer screenings.

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 and the Central MRSA service areas to be from Oct. 15, 2016, to March, 15 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.