Claims and Eligibility

Blue Cross and Blue Shield of Texas works closely with doctors to improve the health care system and meet customers' health care delivery needs. We aim to consistently provide the quality technology, services and information that can help improve all transactions and communication with health care professionals.


BlueCard® Program

The BlueCard Program links participating health care providers and the independent Blue Cross and Blue Shield Plans across the country and around the world through a single electronic network for claims processing and reimbursement. Learn more about BlueCard.


Claim Review Process

Learn more.


Claim Status

After submitting a claim, you can check the status online or via Provider Customer Service's automated phone system Learn more.


Electronic Commerce Solutions

Say goodbye to paper shuffle and say hello to increased operational efficiencies and improved turnaround on payments. BCBSTX is your source for e commerce transactions. Learn more about Electronic Commerce Solutions.


Eligibility and Benefits

Patient eligibility and benefits should be verified prior to every scheduled appointment. Learn more.


Eligibility and Benefits Inquiry (HIPAA 270/271)

An eligibility and benefits inquiry should be completed for every patient at every visit to confirm membership, verify coverage and determine other important information, such as the patient's co-pay, co-insurance and deductible amounts. Learn more.


How to Check Claims Status

Visit www.availity.com  and follow the provider link at the top of the page for more information or call the Provider Customer Service Unit at 1-800-451-0287.


Interactive Voice Response (IVR) System

Enjoy the convenience of self-service inquiry resolution. Learn more.


Medicare Advantage Private Fee-for-Service

If you provide care to a Medicare Advantage Private Fee-for-Service (PFFS) member from an out-of-area Blue Cross and Blue Shield (BCBS) Plan, you may use the Web Finder Tool.


Patient Cost Estimator

The Availity® Patient Cost Estimator (PCE) tool is an online member liability estimator that can help professional and institutional providers estimate a patient’s potential out-of-pocket costs in real-time for office, inpatient and outpatient services provided to BCBSTX members.

Learn more

Physicians' Advisory Committee (PAC)

PAC is a forum for open dialogue on issues related to the relationships and interactions between and among Physicians, their patients and the Blue Plans. Learn more about PAC.


Submitting Claims

At Blue Cross and Blue Shield of Texas, we are committed to fast and efficient claim processing. In order to prevent delays, billing errors and other potential setbacks, we’ve put together valuable tips and information to help you manage and submit claims.