Blue Review
A Medicaid Provider Newsletter

February 2018

Hot Topics

Reminder: The HEDIS® 2018 Season Is Upon Us

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 that steps can be taken to obtain the necessary records in a timely manner.

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Clinical Resources

Update to the TMPPM Gynecological, Obstetrics and Family Planning Handbook for LARC/LARC Devices

A few subsections in the Texas Medicaid Provider Procedures Manual’s (TMPPM) Gynecological, Obstetrics and Family Planning Handbook have been updated to reflect new terminology for intrauterine devices and implantable capsules as long-acting reversible contraceptives (LARC).

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Electronic Visit Verification (EVV): When to Install a Small Alternative Device in the Home

It is required by the EVV program that a small alternative device be installed in a member’s home when a visiting attendant cannot verify their home visit via the member’s home telephone.

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Education & Reference

Taking Action Against Asthma

Are you implementing an asthma action plan with your asthma patients? An action plan is an effective tool for patients and their caregivers/guardians to help avoid attacks and to be prepared when attacks happen.

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Texas Health Steps (THSteps) Medical Requirements and References

Review the federal mandates and state requirements for medical checkups. Also included are links to the THSteps Quick Reference Guide and other helpful resources.

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Webinars

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!

Meeting Information
Join the WebEx meeting: hcsc.webex.com
Meeting number: 626 749 977

Join by phone:
Toll-free: 1-877-249-5777

If you are unable to attend our training sessions, they are available for completion via Brainshark® at your own pace, date and time.

Have You Updated Your Provider Information?

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.

News & Updates

For the most up-to-date information, view the News & Updates section of the BCBSTX provider website.

Link to BCBSTX Medicaid Website

On this website, you will find links to the provider manual, Quick Reference Guide, services requiring prior authorization and other useful information.

Contact Us

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:
Email: TexasMedicaidNetworkDepartment@bcbstx.com
Phone: 1-855-212-1615
Fax: 1-512-349-4848

For member outreach inquiries, BCBSTX’s Medicaid (STAR), STAR Kids and CHIP members may contact Sonia Saenz, Senior Outreach Specialist/Member Advocate at 1-512-349-4883. 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.