July 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 dental benefits changes, claim denials for discharge status, AAPCA Medicaid benefits transitioning to managed care, information specific to CHIP providers and more.

Become a HealthSelect^SM of Texas Provider Today

ERS participants in the HealthSelect POS plan receive maximum benefits when care is provided or directed by an in-network PCP. To continue providing care to your ERS participants, we hope you will participate in our customized HealthSelect network. Please contact your local Network Management office to obtain an agreement to be a BCBSTX HealthSelect provider.

Fee Schedule Updates Effective Oct. 1

Review the upcoming changes that will impact Blue Choice PPO^SM, Blue Essentials^SM, Blue Premier^SM, Blue Advantage HMO^SM and ParPlan effective Oct. 1, 2017.

Reminder

• BCBSTX New Employer Group Plan – Employees Retirement System of Texas (ERS) Effective Sept. 1, 2017

Reminder

• 2017 Blue Essentials Benefit Option Highlights

Careful Documentation Paves the Way for Accurate Coding Capture

Accurate documentation tracks quality of care measures, and can impact public provider profiles and different forms of reimbursement. BCBSTX offers a new video, as well as other helpful tools and services on our website to improve ICD-10 documentation.

Reminder

• Medicare Advantage Plans Overpayment Recovery

The Keys to Unlocking a Great Discharge Summary

Hospital discharge summaries are very important for favorably impacting readmission rates, patient satisfaction and continuity of care. However, key information is often missing. Review five key pieces of information to include in each summary.

Blue Cross Medicare Advantage (PPO)^SM Lab Guidelines

Review BCBSTX’s laboratory guidelines for our preferred outpatient clinical reference laboratory providers. Contact information is provided.

FEP^® Self-measured Blood Pressure Monitoring

Encourage your FEP-eligible patients to check out the FEP Wellness Incentive program where they may qualify for free blood pressure monitors and earn other financial incentives.

Reminder

• eviCore^TM Current and Expanded Preauthorization Requirements

eviCore is a trademark of eviCore health care, LLC, formerly known as CareCore, an independent company that provides utilization review for select health care services on behalf of BCBSTX.

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an Independent Licensee of the Blue Cross and Blue Shield Association

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