Medicaid Member Rights and Responsibilities
Blue Cross and Blue Shield of Texas (BCBSTX) has posted its Medicaid Member Rights and Responsibilities on the BCBSTX provider website. This is an annual posting to ensure our provider community remains informed of our Medicaid Member Rights and Responsibilities.
How to Keep the Cash Flowing: Billing with Appropriate Diagnosis Codes
One of the Top 10 reasons for claim rejections is invalid ICD-10 diagnosis codes. BCBSTX has tips on proper diagnosis coding, including age appropriate health assessments, family planning services and obstetric care.Read More
Focus on Behavioral Health
Depression Is Not Always Major Depressive Disorder
Not all diagnoses of depression are the same. Selecting the most appropriate diagnosis for each patient is important for appropriate treatment and positive outcomes.Read More
Education & Reference
Prenatal and Postpartum Care for the Pregnant Patient
Health care providers play an important role in keeping pregnant patients and babies healthy. BCBSTX wants to ensure that each of our members is receiving appropriate prenatal, postpartum and follow-up care.Read More
Blood Pressure Screening
BCBSTX strives to emphasize the importance of healthy lifestyle choices to our members, including complete health assessments with blood pressure measurement. Along with other best practices, make sure to discuss the importance of heart health, physical activity, healthy nutrition and regular blood pressure screenings with your patients.Read More
Electronic Visit Verification (EVV) Updates
EVV Training Modules Now Available
The Texas Health and Human Services Commission (HHSC) has developed an EVV toolkit to help with the expansion of EVV due to the 21st Century Cures Acts. All training toolkits can be found on Blue Cross and Blue Shield of Texas’ (BCBSTX’s) EVV web page. Training offers basic information, FAQs and tips. More training will be rolled out in 2019.
HHSC Notifications — Stay in the Know!
Health & 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 articles. 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.
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, Director, Quality Improvement, at 1-512-349-4836.
For Electronic Visit Verification questions, please email BCBSTX_EVV_Questions@bcbstx.com.