Discuss Colon Health and Preventive Screening with Members

Preventive screening for colorectal cancer is recommended for adults ages 45 to 75. Review screening tests and tips to close care gaps.

No Referral Needed for Commercial Members to See In‑Network Behavioral Health Provider

In accordance with the Mental Health Parity and Addiction Equity Act of 2008, primary care physicians don’t need to submit referrals for our members with commercial policies to see in‑network behavioral health providers.

Review Prior Authorization Changes for Some Commercial and Government Program Members

We’ve updated prior authorization requirements for certain commercial and government plans to reflect new, replaced or removed codes.

Encourage Follow‑up Care After Hospital Visits for Mental Health

Among Americans ages 18 to 44, nearly 600,000 are hospitalized yearly for mental health‑related conditions, according to the National Alliance on Mental Illness. You can help our members by encouraging timely follow‑up care with behavioral health care providers when appropriate.

New Data on Quality Measures for Reporting Year 2024

Data for reporting year 2024 tracks rates on certain quality measures for members in our commercial HMO, PPO and marketplace HMO and Point of Service plans. Review a summary and interventions that impact them.

Explore Learning Opportunities

We offer free training for providers who participate in our networks. View and sign up for training sessions.

Revalidation Application Required for Second and Third Due Date Extensions

The Texas Health and Human Services Commission implemented additional eligibility criteria for second and third due date extensions. Learn what criteria must be met.

Stay Updated on Medicaid News

You can find information for STAR, STAR Kids and CHIP in Medicaid News and Updates.

GeoBlue^® Is Now Blue Cross Blue Shield Global Solutions^SM

Members will receive BCBS Global Solutions ID cards during this transition. Member coverage, benefits and access to care don’t change.

Verify Your Directory Information Every 90 Days

Our members and other providers rely on our provider directory for accurate information about your practice. As a contracted provider, your directory data must be verified at least every 90 days, even if it hasn’t changed.

Review Pharmacy Program Quarterly Update – Part 1

Changes were made to our drug lists and utilization management program. Learn about these and other pharmacy program updates.

Learn About Updates to Reimbursement Policies

We regularly add and modify reimbursement policies, formerly known as clinical payment and coding policies, as part of our ongoing policy review. See which policies were updated.

Review Active and Pending Medical Policies

Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.