This page may have documents that can’t be read by screen reader software. For help with these documents, please call the number on the back of your member ID card.
You may need to preauthorize certain covered health services to ensure you avoid unexpected costs. Preauthorization means that you need to get approval from your health insurance before you can have certain health services performed. This is important to know before you get these services, so we can help you avoid higher costs.
Usually, your network provider will take care of this before the service is performed. But it’s best to confirm for yourself. Call 1-800-441-9188 before you get care.
A predetermination of benefits is a review by medical staff to determine if the service you are requesting is appropriate for your medical needs. Predeterminations are done prior to services so that the patient will know in advance if the procedure is covered under their group benefit plan.
Your benefit plan allows coverage for services that are determined to be "medically necessary." To assist in evaluating whether a service or treatment is medically necessary under the terms of your Plan, Blue Cross and Blue Shield of Texas (BCBSTX) has developed and applies medical policies.