January 2019
Hot Topics
Long-term Services and Supports (LTSS) Enrollment Notice
The Texas Health and Human Services Commission (HHSC) requires LTSS providers to enroll in the Texas Medicaid program by Feb. 1, 2019, or they will not receive payment for all or some of the LTSS services they’ve provided. Please review the recent notice for LTSS providers.
New Morphine Dose Limitation Begins this Month
Review the new daily morphine milligram equivalents limit that goes into effect Jan. 28, 2019, for members with STAR, STAR Kids and CHIP prescription drug coverage.
Read MoreHEDIS® Hybrid 2019 Performance Measures
Read a letter from Dr. Jerald Zarin, Medical Director, Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid and Government programs, about performance measures for HEDIS Hybrid 2019.
Featured Tip
How to Keep the Cash Flowing: Submitting Corrected and Duplicate Claims
Keep the cash flowing by reviewing the do’s and don’ts of submitting corrected and duplicate claims.
Read MoreFocus on Behavioral Health
Behavioral Health Screening Resources for the Primary Care Setting
Access behavioral health resources such as training, educational materials and community offerings for medical providers from the Texas HHSC, Texas Health Steps and Magellan Healthcare®.
Read MoreElectronic Visit Verification (EVV) Updates
HHSC Notifications — Stay In the Know!
Make sure you’re periodically reviewing the Texas HHSC website for new notices about EVV that you should be aware of. You can also read the most recent EVV updates on BCBSTX’s provider website.
Education & Reference
Availability of Utilization Management Criteria
BCBSTX offers Utilization Management criteria to providers upon request and in denial notifications. Criteria will be mailed, faxed or emailed to providers upon request. To receive a copy, call BCBSTX at:
- 1-877-560-8055 for STAR or CHIP members
- 1-877-784-6802 for STAR Kids members
Medical Policies: We Want Your Feedback
Learn how to view medical policies — even those that are pending — and how to add your comments about those policies. We welcome your feedback.
Read MoreHealth & Wellness
Health Tips to Share
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.
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 and Updates
For the most up-to-date information, view the News and 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
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, Director, Quality Improvement, at 1-512-349-4836.
For Electronic Visit Verification questions, please email BCBSTX_EVV_Questions@bcbstx.com.