Predetermination Request Form and New Texas Standard Prior Authorization Request Form Blue Cross and Blue Shield of Texas (BCBSTX) has revised its current Predetermination Request Form that is to be completed and submitted whenever a provider wants to request a predetermination to establish medical necessity and available benefits. The Predetermination Request Form can be found on the BCBSTX provider website in the General Forms section. Pursuant to Texas Insurance Code Chapter 1217, effective Sept. 1, 2015, health plans that require preauthorization must accept preauthorization requests submitted using the Texas Standard Prior Authorization Request Form for Health Care Services adopted by the Texas Department of Insurance. Please note that BCBSTX currently does not require the use of a preauthorization form, therefore BCBSTX will not require the use of the Texas Standard Prior Authorization Request Form for Health Care Services, but will accept preauthorization requests using the form should a provider choose to use it. The Texas Standard Prior Authorization Request Form for Health Care Services is available on the BCBSTX website in the General Forms section. The above referenced forms are two different and separate forms. When submitting either of these forms to BCBSTX, please use the following applicable fax # or address:
If you have any questions, please contact your Network Management office:
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