What is iEXCHANGE?
The iEXCHANGE System is Blue Cross and Blue Shield of Texas' automated precertification & referral system. iEXCHANGE offers both telephone (interactive voice response - IVR) as well as a web-based application. iEXCHANGE supports the direct submission and processing of referrals and precertifications by network physicians, professional providers and facilities within Texas.
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What are the hours of availability for the iEXCHANGE Systems?
Both the iEXCHANGE IVR and Web applications are available 24 hours a day, 7 days a week - with the exception of every 3rd Sunday when the system will be unavailable from 11:00am - 2:00pm CST.
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Once we determine who our Office Administrator will be, who do we contact to get them signed up / started for iEXCHANGE Web?
Procedures and details are available online for the Office Administrator’s set-up for iEXCHANGE Web. Go to UM/QI/Medical Management, click on iEXCHANGE and go to “Getting Set-Up with iEXCHANGE”, then complete and submit the Set-Up Form.
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How long before the Office Administrators can begin inputting their users and provider listings into the iEXCHANGE Web application?
Once the Office Administrator's “login” for their iEXCHANGE Web account has been established, the Office Administrators can begin immediately.
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If I am having trouble is there a Support Desk for iEXCHANGE?
Yes, you can reach the Texas iEXCHANGE Support Desk by calling 1-800-441-9188, select 1, then select 4. The Support Desk can be reached Monday - Friday during the hours of 8:00am - 5:00pm CST.
The support desk assists providers when they are having difficulty utilizing the iEXCHANGE IVR or Web applications, ie. diagnosis codes, reporting issues with iEXCHANGE, resetting Office Administrators' passwords, etc.
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How do I access the iEXCHANGE Systems?
For the IVR - dial 1-800-413-0869.
For the Web application - after your Office Administrator sets up your User ID and Password, go to the BCBSTX Provider Web site, then go to UM/ QI/ Medical Management, click on iEXCHANGE.
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Can my provider ID number be used with the iEXCHANGE System
For the IVR & Web, you will need your NPI number found in the online provider directory, Provider Finder, on the BCBSTX Provider Web site.
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What type of transactions can be processed in the iEXCHANGE Systems?
Both the IVR and Web applications support the following transactions:
- Inpatient Certifications,
- Maternity Notifications, and
- Referrals
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When entering the member ID, should the 3-letter alpha prefix be entered in the IVR application?
No, the 3-letter alpha prefix is not needed with the exclusion of the Federal Employee Program (FEP) Members.
Exception: For FEP Members whose IDs begin with an “R”, enter a leading *73 followed by the remaining numbers.
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Will the iEXCHANGE IVR accept the patient's social security number?
No, the IVR will not accept the social security number. All members in Texas have a unique identification number on their member ID card.
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Does iEXCHANGE IVR or Web application list the member's PCP?
For the IVR - No.
For the Web application - it does not display on a member inquiry, authorization preview or confirmation pages. However, it does display on a treatment search (authorization inquiry) page.
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How can I get access to a Provider Directory?
HMO Blue Texas and BlueChoice provider directories are available online at www.bcbstx.com/provider, select Provider Finder in the title bar.
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Are there certain groups that will not go through iEXCHANGE?
Texas Health Insurance Risk Pool - Group #059473. If you have any questions, please contact the Medical Care Management Department at 1-800-441-9188, select 1, then select 3.
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Does the diagnosis code on the specialist's claim have to match the diagnosis in iEXCHANGE exactly?
No. The diagnosis code that the specialist submits does not have to match the diagnosis code entered into the iEXCHANGE System by the Primary Care Physicians (PCP).
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Posted 07/30/08
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