We’ll Conduct coordination of Benefit Reviews for Medicaid Claims to Identify Potential Overlaps in Coverage

Aug. 10, 2026

Effective Nov. 1, 2026, we’ll work with Machinify to conduct coordination of benefit reviews to identify potential overlaps in coverage affecting accurate claim payments.

This postpay review applies to Medicaid members with Blue Cross and Blue Shield of Texas.

What happens next? This review will identify members with overlaps in health coverage and facilitate more efficient claim adjudication. The process identifies whether members have other insurance, such as through a spouse or employer, to determine the primary and secondary payer, avoiding duplicate payments.

Postpayment recovery: If a claim was paid, but it is later found that another insurer was primary, we’ll recover that payment.

Watch News and Updates for updates.

Machinify is an independent company that has contracted with BCBSTX to provide utilization management services for members with coverage through BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.