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Coming Soon: Electronic Provider Access Tool for Out-of-Area Members

June 9, 2014

Electronic Provider Access (EPA) is a new tool that will enable providers to initiate online pre-service reviews for out-of-area Blue Plan members. The term “pre-service review,” as used with this tool, refers to benefit preauthorization, pre-certification, pre-notification and prior approval functions. Conducting a pre-service review is not a substitute for checking eligibility and benefits.

The EPA tool will be available to Blue Cross and Blue Shield of Texas (BCBSTX) independently contracted providers who are registered AvailityTM Web Portal users. After checking eligibility and benefits, you will be able to access the EPA tool via the Authorizations link under the “Auths and Referrals” menu. Upon entering the alpha prefix from the member’s ID card, you will be securely routed from Availity to the EPA landing page on the member’s Home Plan portal.    

Attend a Webinar to Learn More
BCBSTX will be hosting webinars in July and August to introduce you to the EPA tool – where to find it and how to use it. To register now, select your preferred date and time from the list below. 

July 8, 2014, 10 to 11:30 a.m., CT 
July 24, 2014, 2 to 3:30 p.m., CT 
Aug. 5, 2014, 2 to 3:30 p.m., CT 
Aug, 21, 2014, 10 to 11:30 a.m., CT 

For details on registration with Availity, visit availity.com . Also watch the News and Updates section of the BCBSTX Provider website, as well as upcoming issues of the Blue Review, for announcements and related resources.

Depending on differing implementation schedules, the EPA tool may not be available for some Blue Plans.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.

Please note that verification of eligibility and benefits information, and/or the fact that any pre-service review has been conducted, is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.