All currently contracted FMSAs who work with a Managed Care Organization (MCO) must attend a mandatory webinar on Tuesday, March 6. The training is a condensed version of the Texas Department of Health and Human Services Commission’s (HHSC) FMSA enrollment training. A registration link is provided.Read More
Review the HEDIS HYBRID 2018 measures that are up for performance review. Also, some measures require information directly from patient medical records that are kept at the physician’s office. As such, we may contact your office with a list of patients whose medical records need to be reviewed. If your office uses a third-party vendor for medical records, please notify us immediately so steps can be taken to obtain the necessary records in a timely manner.Read More
To provide the best service to you and your patients, it's very important that all the information Blue Cross and Blue Shield of Texas (BCBSTX) has about your practice is current and accurate. Be sure to let us know about any changes to your practice address, email and/or physician rosters. Keeping us informed of any changes to your information helps us pay your claims more quickly and accurately. It also makes it easier for your patients to get current and correct information on our Provider Finder®. You can update your information by completing the Demographic Change form.
Review appointment standards for general appointment scheduling, services for members under age 21 and over age 21. Failure to comply with outlined standards may result in corrective action.Read More
Make sure you’re up to date on the new STAR Kids requirements for PDN.Read More
The HHSC has a contract in place for you to use two Spanish translation vendors; information on how to do so is included. Also, your office should have quality improvement strategies in place to ensure the competency of the interpreters, translators and bilingual staff who provide direct health care services in languages other than English.Read More
As of Feb. 12, 2018, mosquito repellent for the prevention of Zika became a continuous benefit for BCBSTX’s Children’s Health Insurance Program members. MCOs should have already begun adjudicating claims on that date. Read on for benefit details and what non-compliant MCOs should do in the interim.Read More
Review the required components that must be done during all THSteps and well-child exams.Read More
Given the severity of this year’s flu season, it’s important that your patients have timely access to your office if they’re experiencing flu symptoms. Continue recommending the flu vaccine for everyone ages 6 months and older, and educating your patients about flu prevention.Read More
Help your patients live a healthier life by sharing relevant wellness information with them. You can print individual articles, or point your patients to the websites so they can review topics that interest them. Anyone can access the websites; no login required.
Connect invites users to get answers, share information and gain knowledge on topics like well-being and health coverage through blogs, videos and downloadable content. Participants can create a profile and like posts, add their opinions in the comments and subscribe to content they’re interested in. Spanish content is available.
If you are a newly contracted provider or an existing provider who needs a refresher on topics related to Texas Medicaid, please consider attending one of our weekly webinars.
Provider training with the Texas Medicaid Network Department will occur every Friday from 12:30 – 2 p.m. CT. The topics for these trainings will vary and meeting details will be updated and posted on BCBSTX’s Medicaid provider website.
Request Meeting Topics!
Please email the Texas Medicaid Network Department to request training topics!
Join the WebEx meeting: hcsc.webex.com
Meeting number: 626 749 977
Join by phone:
Visit the BCBSTX provider website to update any changes to your address, telephone number, group affiliation, and/or any other material facts via the Provider Data Update Notification form. Also, update your information with Texas Medicaid & Healthcare Partnership via their Provider Information Change form.
For the most up-to-date information, view the News & Updates section of the BCBSTX provider website.
On this website, you will find links to the provider manual, Quick Reference Guide, services requiring prior authorization and other useful information.
Eligibility, Benefits, Provider Network Referrals and Claim Status
Medicaid (STAR) and CHIP Customer Service: 1-877-560-8055, Monday - Friday, 8 a.m. - 8 p.m. CT
STAR Kids Customer Service: 1-877-784-6802, Monday - Friday, 8 a.m. - 8 p.m. CT
For general questions and concerns:
For member outreach inquiries, BCBSTX’s Medicaid (STAR), STAR Kids and CHIP members may contact Zenaida Martinez Nava, Senior Outreach Specialist/Member Advocate at 1-512-349-4880. If the member is unable to reach Sonia, please contact Maria Izquierdo at 1-512-349-4887.
For BCBSTX Medicaid (STAR), STAR Kids and CHIP quality inquiries, please contact Kathleen Thompson, Manager Medicaid Quality, at 1-512-349-4836.
For Electronic Visit Verification questions, please email BCBSTX_EVV_Questions@bcbstx.com.
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