| More Enhancements Coming to the iExchange® Benefit Preauthorization Tool We’ve made enhancements and continue to improve iExchange, our Web-based benefit preauthorization tool. iExchange supports requests for behavioral health, pharmacy and medical/surgical treatment services. iExchange allows you to submit initial and extension requests for approval prior to services being rendered. We strongly encourage you to verify your patients’ eligibility and benefits to determine coverage and benefit preauthorization requirements prior to using the tool. This flexible tool provides real-time responses for direct submission of inpatient admissions and select outpatient medical services, including benefit preauthorization submissions after regular business hours and on weekends. Recently, Blue Cross and Blue Shield of Texas (BCBSTX) deployed what was formerly known as the Patient Clinical Summary. iExchange now offers an updated version called the Health Summary. Providers are able to receive additional data in the Health Summary, including more real-time data, which is the result of BCBSTX’s efforts to give you access to more data and better analytics that can help improve the health of your patients. The Health Summary will display the following information:
Coming Soon to iExchange Please note the fact that a service has been preauthorized/pre-certified is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. |
