A Message from Our President: In the Face of COVID-19, We’re Standing by You and Our Members, Your Patients
The novel coronavirus (COVID-19) pandemic has tested our health care delivery system, economy and culture in ways that many of us could not imagine. Both the heroism and human frailty of health care providers during this pandemic has been undeniable. The tension between personal and family safety while delivering life-preserving care has been prominent in our minds. And despite the modern advances of health care, we are reminded of the critical importance of public health and the interwoven nature of our health as one community.
In between the chasms in our health care system, you have helped bridge the gap – overcoming fears, innovating in the face of equipment shortages, enduring back-to-back clinical shifts, and comforting patients and families during a time of uncertainty. On behalf of BCBSTX, thank you for your service to our community.
As we continue to monitor and make changes in response to this rapidly evolving pandemic, I want to take a moment to personally let you know how we are holding true to our purpose – to do everything in our power to stand with our members in sickness and in health. We took several early actions to complement your efforts to prepare for the surge of COVID-19 patients:
- Doubled the availability of our care management team on the weekends to support providers and members
- Extended our weekday hours and accelerated proactive outreach to patients at greatest risk for COVID-19 infection to address their social needs
- Helped to expedite discharge of our inpatient members to post-acute settings through relaxed prior authorization requirements
- Relaxed some prior authorization requirements in support of the rapidly evolving diagnostic and care protocols for COVID-19
- Expanded access to telemedicine and telehealth services to promote continuity of care for members and mitigate transmission of COVID-19 for some clinical interactions
We’re also contributing community grant funds to help local non-profits support health care workers and members with essential needs.
Now more than ever, communication is critical. With this special edition of our Blue Review, we’ve combined recent COVID-19 communications and introduced new information. In addition, our COVID-19 Preparedness page provides a quick overview of the latest updates. I encourage you to watch the News and Updates page for additional announcements, which will be posted as soon as more information becomes available.
Dan McCoy, M.D., President of Blue Cross and Blue Shield of Texas
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
Provider Information on COVID-19
We launched a COVID-19 Preparedness page to keep you up to date on information you may need to diagnose and treat our members related to COVID-19. It includes information on benefit coverage and claim filing for testing of the 2019 novel coronavirus (COVID-19) for most members with no prior authorization needed and no member copays or deductibles.
BCBSTX Waives Customer Cost-Sharing for COVID-19 Treatment
On April 2, we began waiving member cost-sharing, including deductibles, copayments and coinsurance, related to treatment for COVID-19 received from April 1, 2020, through May 31, 2020, for fully insured group plans, individual and family plans, Medicaid STAR, CHIP, STAR Kids and Blue Cross Medicare OptionsSM. The waiver applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies.
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Using Telemedicine and Telehealth in Response to COVID-19
In response to COVID-19, we are temporarily expanding coverage for medical and behavioral health telemedicine and telehealth visits. We are also giving many of our members access to covered, medically necessary behavioral health and medical services delivered through telemedicine or telehealth with no copays or deductibles for in-network visits in response to the coronavirus outbreak.
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Pharmacy: Early Medication Refills During COVID-19 Outbreak
To make it easier to get early prescription refills, we have temporarily lifted restrictions. (Note: These prescription fill rules may differ for self-funded plans.)
- Members can contact their pharmacy directly to ask for an early fill. That fill will be for the same quantity as the last prescription filled.
- Pharmacists have approval to provide an early fill on most medications.
- Members can also use their 90-day supply benefits for covered non-specialty medications at select retail pharmacies or home delivery (mail order) . Members can log in to Prime Therapeutics®
or call the number on their BCBSTX member ID card.
Note: This early fill information applies if members have BCBSTX pharmacy benefits administered by Prime Therapeutics. Also, all safety measures, prior authorization reviews, as well as prescribing and dispensing laws, still apply.
BCBSTX contracts with Prime Therapeutics (Prime) to provide pharmacy benefit management and other related services. BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime.
Types of Telemedicine/Virtual Visits – Texas Medicaid
Providers may need to utilize telemedicine/virtual visits to access our Medicaid members. Review information on three types of visits and coding for Medicaid patients.
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Texas COVID-19 Testing Sites
If available, you can complete COVID-19 tests in your office and send the specimens to our participating labs for results. In addition, providers can refer members to various testing sites around Texas.
Members can get tested for COVID-19 at drive thru locations in certain parts of Texas.
A list of the drive-thru testing sites is available on Texas Department of State Health Services (TDSHS) . These testing sites are not run or overseen by TDSHS. Information is only accurate at the time the list is posted. Please check the TDSHS website for most current information.
Credentialing Changes Due to COVID-19
We are temporarily updating our credentialing policy and processes in response to the COVID-19 emergency. Visit our COVID-19 Preparedness page for details.
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Minority Health Month Spotlights Importance of Physical Activity for Overall Wellbeing
According to the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH), April is National Minority Health Month . The 2020 theme is Active & Healthy. During this unprecedented time of social distancing and self-isolation, staying active may be more important than ever.
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Stay Informed on COVID-19
During these continuously changing times, please check our News & Updates and COVID-19 Preparedness pages for the most recent information on the COVID-19 pandemic.
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Do you have questions for our Provider Representatives?
Contact your local Network Management Office, if you have questions.
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an Independent Licensee of the Blue Cross and Blue Shield Association
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