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Blue Review

A newsletter for physician, professional, facility, ancillary and Medicaid providers

April 2020


Monthly News for Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid (STAR), STAR Kids and CHIP Providers

Read this month’s Medicaid news to learn about:

Notices & Announcements

Provider Information on COVID-19 Coverage

We’re all in this together. We are covering testing to diagnose the 2019 novel coronavirus (COVID-19) for most members with no prior authorization needed, and no member copays or deductibles.

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Telemedicine and Telehealth Coverage Expansion in Response to COVID-19

The bottom line: We’re responding to COVID-19 by expanding our coverage for medical and behavioral health telemedicine and telehealth visits. This allows members to access care while reducing their risk of exposure.

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iExchange® Deactivates April 15, 2020 — Use Availity Authorization & Referrals

iExchange is being deactivated on April 15, 2020. Be sure to transition to Availity Authorizations & Referrals for online prior authorization and referral submissions. Check News and Updates on our provider website for additional information.

Behavioral Health

2019 Behavioral Health Quality Improvement Program Evaluation Executive Summary

Looking ahead: Based on the review of our 2019 program goals, an increased understanding of barriers to improvement and lessons learned during 2019, we have narrowed our focus areas to improve our behavioral health program.

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Claims & Eligibility

Clarification: New BCBSTX 837 Commercial Claim Validation Edits Effective April 1, 2020

What’s changed: Beginning April 1, we implemented new electronic claim submission validation edits for commercial professional and institutional claims (837P and 837I transactions). Learn what this means and what you should do.

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Clinical Payment and Coding Policy Updates

The Clinical Payment and Coding policies published on our website describe payment rules and methodologies for CPT®, HCPCS and ICD-10 coding for claims submitted as covered services. This information is offered as a resource for our payment policies; it is not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process. The following policy was recently added:



Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2020 — Part 2

Review drug list changes, updates and revisions that go into effect April 1. Adobe Acrobat Icon


Health & Wellness

New Annual Wellness Visit Resources for Medicare Providers

Making life easier: To help meet Medicare requirements, we’ve launched two new resources for you to document patient visits.

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Network Participation

Using the Online Tool to Search for Doctors and Hospitals

Easy way to stay current: Use our online Provider Finder® tool to ensure your information is correct/up-to-date so members have an easy time connecting with you.

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Prior Authorization Information


Education & Reference

Complimentary Webinar Trainings Available

Do you have new staff or need a refresher about electronic options? If yes, we have added complimentary educational webinar sessions on the BCBSTX provider website for provider billers, utilization areas and administrative departments. Topics include Availity 101, Availity Authorizations & Referrals and Remittance Viewer. Please visit the Provider Training page on our provider website throughout the year to view available training topics and sign up for sessions.

Health & Wellness Tips to Share

The Connect Community provides articles, blogs and videos, and visitors can ask questions and get answers. Topics include everything from improving well-being to explaining health coverage. Spanish is available.


Did You Know?

Did You Know (formerly In Every Issue) provides an ongoing collection of articles to assist provider offices with servicing BCBSTX members. Access this month’s articlesAdobe Acrobat Icon.

BCBSTX is required to provide certain notices in all published correspondence with physicians, professional providers, and facility and ancillary providers. For the latest updates, visit the News and Updates section of the BCBSTX provider website.

Printable PDF

View a printable PDFAdobe Acrobat Icon of the non-Medicaid information in this newsletter.

Contact Us

View our quick directory of contacts for BCBSTX.

Update Your Information

Do you need to update your location, phone number, email or other important details on file with BCBSTX or want to receive the Blue Review by email? Use our online form to request information changes.

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A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association

1001 E. Lookout Drive, Richardson, TX 75082

© Copyright 2020 Health Care Service Corporation. All Rights Reserved.

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