Welcome, Providers Company Information
Blue Cross Blue Shield of Texas
   
         
     
 
Home > Providers

         
What's New
Attention Professional Electronic Submitters
Evidence Based Reimbursement
Clotting Factor Product Initiative
Coordination of Benefits and Patient Share
Maternity Program: A Healthy Start for Mothers and Babies
Downtime Alert - RediLink Production System
Guaranteed Coverage to all Affected UniCare Members
Untimed Billing Procedure CPT Codes
Walmart Behavioral Health Benefit Announcement
Provider Claim Summaries on all Adjustments - Coming Soon!
Special Coverage for H1N1 Vaccine
EDI Update
PCS to EPS: 30-Day Transition Reminder
eCards for Health
Important - New Process for Use of Out-of-Network Providers - Effective December 1, 2009
Clear Claim Connection 4.0
New Availity Claims Research Tool can improve your claims accuracy, office efficiency
Proper Speech Therapy Billing
FDA New Warnings/Proposed Changes to Acetaminophen Products
Medicare Corrected Claims
Corneal Transplant Predeterminatiion Process
Are You Billing for Compound Drugs?
Availity Participating Provider Training Webinars - November 2009

Disclosure Notices
Evidence Based Reimbursement
Change to the HMO Blue Texas Outpatient Clinical Reference Lab Services effective November 1, 2009
Code Auditing Upgrade & Modifier 59 Exempt Auditing - eff Oct 19, 2009
Quarterly Drug and Home Infusion Drug Fee Schedule Updates effective 12/1/09 have been posted under Reimbursement Schedules as of 9/1/09
Fee Schedule Update

Provider Education

Blue Review
Distribution date of November 6, 2009

Blue Review
Issue 3 - 2009

Blue Review Archives
   
Electronic Commerce
  • Alerts
  • Availity L.L.C.
  • eCare/NDAS Online
  • EDI Format Specifications
  • EDI Transactions
  • EFT/ERA Forms
  • Electronic Funds Transfer (EFT)/Electronic Remittance Advice (ERA)
  • Electronic Provider Tools Reference Guide
  • Electronic Refund Management (ERM) is here!
    eRM Webinars
    - Sept 2009
  • Explore Paperless Possibilities
  • HIPAA
  • iEXCHANGEŽ Web -
    Automated Precertification
    and Referral System
     

         Getting Set-Up with
           iEXCHANGE Web

     

         Web Reference Guide

             Web Tip Sheet
  • Online Transaction Tip Sheets
  • RealMed

    Provider Library
  • BlueCard®
  • BlueCompare for Physicians
  • BlueCompare for Hospitals
  • Bridges to Excellence
  • Claim Appeal/ Reconsideration Review Process & Billing Dispute External Review Process (BDERP)
  • Claim Pointers
  • Evidence Based Measures
  • Facility Out-of-Network Care Enrollee Notification Form - New Process Effective December 1, 2009
  • FAQs
  • Learn More About
    BlueChoice Solutions
    Blue Medicare PPO

         Mandatory Provider
           Fraud, Waste & Abuse
           Training

    Blue Medicare Private
       Fee-for-Service
         Terms and Conditions
    HealthSelect
    TriWest
  • National Provider Identifier
  • Physician Advisory Committee (PAC)
  • Provider Education
    New Provider Orientation
    Existing Provider
      Orientation
    Refresher Orientation
    Time to be Blue
  • Provider Manuals Requires password for access
  • Reference Guides
  • Special Investigations Tutorial
  • Wellness Initiatives/Programs
    General Reimbursement Information
  • Bundling Information Requires password for access

    Clear Claim Connection
     
  • Recoupment/Refund Requires password for access
     
  • Schedules Requires password for access
     
  • Significant Edits Requires password for access
     
  • ...and more... Requires password for access

    Medical Policy
  • Draft Medical Policies

  • Active/Pending Medical Policies

     
  • Medical Policy Medical Records Documentation Guidelines (Predeterminations/Claims)

    Credentialing/
    Contracting
  • Ten Great Reasons to be Blue
  • Provider Record/ Credentialing
  • Consent to Assignment of Provider Contracts (Change of Ownership-CHOW)

    UM/QI/Medical Management
  • Behavioral Health Medical Necessity Criteria

  • Clinical Practice and Behavioral Health Guidelines
  • Clotting Factor Product Initiative
  • iEXCHANGE® - Automated Precertification and Referral System
  • Postpartum Depression - The “Andrea Yates Bill”
  • Radiology Quality Initiative/Preauth Prgm
  • Step Therapy Guidelines for City of Houston (COH)
     
  • Wellness Guidelines
     
    Pharmacy
  • Digitek Recall
  • Medicare Part D Updates
  • Medicine Safety Project
  • Override Request (pdf - 18k)
  • Preferred Drug Guide
  • Proton Pumps (pdf - 28k)
  • Quantity vs. Time
  • Specialty Programs
    Triessent
    Factor Drugs (Accredo)
    Lupron (TAP Pharmacy   Solutions)
  • Step Therapy/Prior Authorization
  • Synagis & RSV
  • Topical Verapamil

    Provider
    Tools/Programs
  • Be Smart. Be Well.TM
    Address Childhood
      Obesity Epidemic
    Caregiving
    Mental Health
      Announcement
  • Blue Distinction
  • Care Comparison® Tool
  • Obesity Management Tool Kit Web Site


     

     
    Requires password for access Requires password for entry
     
     
    A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

    © Copyright 2008. Health Care Service Corporation. All Rights Reserved.

    Home | Important Information