ALERT CONCERNING COVERAGE FOR DISPLACED BCBSTX MEMBERS

Blue Cross and Blue Shield of Texas is prepared to assist members displaced by Hurricane Gustav. We have put in place some temporary exceptions to procedures in order to best respond to the needs of our members displaced by the hurricane.

• BCBSTX is temporarily suspending the contractual requirement for the use of network providers during the disaster response. Payment will be at in-network benefit levels at allowable amounts.
• We are also waiving pre-authorization and referral requirements for displaced members.
• A temporary hotline has been set up to provide clinical summary records on members. Beginning Thursday, Sept. 4, call 888-421-5843 to be connected to a representative who can assist your office in obtaining the needed clinical history information. The hotline will be answered 9 a.m. to 4 p.m. Central time, Monday through Friday.
• You will be asked for the member’s ID number or other identifying information. The representative will then fax the patient clinical summary record to your office, emergency room or clinic.
• If a patient does not have their member ID number, they will need to call us at 800-521-2227 to retrieve their information. If the patient is unable to communicate due to illness or injury, you will need to provide care using normal emergency care procedures.

For prescriptions, certain procedures also will be temporarily waived for displaced members.

• Early refill requests by members will be honored upon request.
• If requested by members, mail order prescriptions will be shipped overnight.
• Mail order deliveries will be attempted at alternate addresses, if requested.
• Mail order prescriptions can be transferred to a local retail pharmacy where the member can pick up the prescription.
• The member copayment for replacement medications will still apply.
• We will provide directions and assistance on transferring prescriptions to other retailers and from mail order to retail.

BCBSTX is also prepared to assist providers in caring for members of other states’ Blues plans displaced by the disaster, as well as volunteers and relief workers from across the country. Process the patient as you would a BCBSTX member and we will work on your behalf to adjudicate the claim with the member’s plan.

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