Blue Review
A newsletter for Medicaid providers

November 2019

Featured Tip

How to Keep the Cash Flowing: Billing BCBSTX Medicaid as a Secondary Insurance

Learn the ins and outs of billing Blue Cross and Blue Shield of Texas (BCBSTX) as secondary for Medicaid claims. To keep the cash flowing, it’s important to remember that if a commercial payer exists, then Medicaid is always the payer of last resort.

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Claims & Eligibility

New Addresses for Submitting Payments for Refund Requests

Beginning Dec. 1, new addresses will be used for submitting claim overpayments and refund/recovery returns. To avoid payment delays, make sure to use the correct addresses.

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Clinical Resources

Preventive Care Guidelines (PCG) and Clinical Practice Guidelines (CPG) Updates

Review the updates to the PCGs and CPGs to ensure you are providing the best care for your patients, our members.

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Influenza Season 2019-2020

Review statistics, resources and options to share with your patients about this year’s flu season.

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Electronic Visit Verification (EVV) Updates

EVV Training Modules 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 Actsleaving_site Icon. 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.

HHSC Notifications — Stay in the Know!

Make sure you’re periodically reviewing the Texas HHSCleaving_site Icon website for new notices about EVV that you should be aware of. You can also read the most recent EVV updates on BCBSTX’s EVV web page.

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.

ConnectConnect 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.

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.