Claims and Eligibility
Blue Cross and Blue Shield of Texas works closely with doctors to improve the health care system and meet customers' health care delivery needs. We aim to consistently provide the quality technology, services and information that can help improve all transactions and communication with health care professionals.
The BlueCard Program links participating health care providers and the independent Blue Cross and Blue Shield Plans across the country and around the world through a single electronic network for claims processing and reimbursement. Learn more about BlueCard.
Say goodbye to paper shuffle and say hello to increased operational efficiencies and improved turnaround on payments. BCBSTX is your source for e commerce transactions. Learn more about Electronic Commerce Solutions.
An eligibility and benefits inquiry should be completed for every patient at every visit to confirm membership, verify coverage and determine other important information, such as the patient's co-pay, co-insurance and deductible amounts. Learn more.
Visit www.availity.com and follow the provider link at the top of the page for more information or call the Provider Customer Service Unit at 1-800-451-0287.
- Behavioral Health Eligibility and Benefits Caller Guide
- Behavioral Health Preauthorization Caller Guide
- Claims Caller Guide
- Eligibility and Benefits Caller Guide
- Inpatient Preauthorization Caller Guide
- Outpatient Preauthorization Caller Guide
- Preauthorization: Extend a Request
- Preauthorization: Check Status Request
If you provide care to a Medicare Advantage Private Fee-for-Service (PFFS) member from an out-of-area Blue Cross and Blue Shield (BCBS) Plan, you may use the Web Finder Tool.
PAC is a forum for open dialogue on issues related to the relationships and interactions between and among Physicians, their patients and the Blue Plans. Learn more about PAC.
At Blue Cross and Blue Shield of Texas, we are committed to fast and efficient claim processing. In order to prevent delays, billing errors and other potential setbacks, we’ve put together valuable tips and information to help you manage and submit claims.