December 2015

(Electronic distribution December 2, 2015)

Managing Your Patients' Questions on Their Individual Plans
In light of the open enrollment season, Blue Cross and Blue Shield of Texas (BCBSTX) providers are getting questions from patients about changes to our individual health plans. We recently sent providers an alert to help guide them through these specific changes. Please review the alert.

Enrollee Notification Form Required for Out-of-network Care
Effective Jan. 1, an out-of-network care form will be required for members enrolled in Blue Choice PPO^SM and Blue Advantage HMO^SM (for Blue Advantage Plus point-of-service benefit plan).

Notices and Announcements
In this issue of the newsletter, we remind you about the proper procedure to reversing and correcting claims when claim adjudication results have been modified from a previous report. We also note that our ICD-10 help desk will be discontinued as of Dec. 31 and that there is a Dec. 10 webinar on Blue Advantage HMO^SM and Blue Advantage Plus^SM.  Get the details.

In Every Issue
BCBSTX is required to provide certain notices in all published correspondence with physicians and professional providers. For the latest updates, visit the News and Updates area of the BCBSTX provider website. Get started now on reviewing this month's articles.

Contact Us
View our quick directory of contacts at BCBSTX.

Update Your Contact Information
Accurate provider directories are an important part of providing BCBSTX members with the information they need to manage their health.

To update your contact information,you should submit all changes at least 30 days in advance of the effective date of change. Please submit your correspondence via:

• fax: 972-231-9664
• mail: P.O. Box 650267, Dallas, Texas, 75265-0267

If your specialty, practice information/status or board certification is not correct on the BCBSTX Provider Finder^®, or if you would like to have a subspecialty added, please contact your Network Management office.

In addition, BCBSTX periodically identifies providers who have not submitted claims for a period of one year. We make an effort to contact each provider to confirm their information. If the provider does not respond, we will initiate a network termination. Similarly, BCBSTX will inactivate any tax identification numbers (TINs) under which there have been no claims submitted for a period of one year.

Blue Review is published for Blue Choice PPO^SM, HMO Blue Texas^SM, Blue Cross Medicare Advantage (PPO)^SM, Blue Advantage HMO^SM and ParPlan contracting physicians and other health care providers. Ideas for articles and letters to the editor are welcome; email BlueReviewEditor@bcbstx.com.

The information provided in Blue Review does not constitute a summary of benefits, and all benefit information should be confirmed or determined by calling the customer service telephone number listed on the back of the member ID card.

BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent, third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or services they offer. If you have questions regarding any of the products or services mentioned in this periodical, please contact the vendor directly.

Blue Cross^®, Blue Shield^® and the Cross and Shield symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.