Interactive Voice Response (IVR) System

For most Blue Cross and Blue Shield of Texas (BCBSTX) members, if you cannot submit your eligibility and benefit inquiries online, this information can also be easily obtained through our Interactive Voice Response (IVR) automated phone system. If you have questions or need to request a claim adjustment, a document control number (claim number) is required.

  • You may access the IVR by calling Provider Customer Service at 1-800-451-0287. Hours of availability are: Monday through Friday, 6 a.m. – 11:30 p.m. (CST), and Saturday, 6 a.m. – 6 p.m. (CST).
  • Simply provide your National Provider Identifier (NPI) when prompted* (you may speak or enter your information by touch-tone).

* Providers who do not have an NPI or are calling from out-of-state may speak or enter their tax ID number (TIN) when prompted by the IVR; however, these providers must specify their provider type, specialty and network status to receive a quote of benefits.

NPI Guidelines**

  • Physician or solo practitioner must use the Type 1 NPI number.
  • Physicians or practitioners that have incorporated with both a Type 1 & Type 2 NPI must use the Type 1 NPI number.
  • Physicians or practitioners that are part of a group practice must use the rendering provider's Type 1 NPI number.
  • Radiologists, anesthesiologists and other medical providers must use the Type 1 NPI number.
  • Medical Groups must use the rendering provider's Type 1 NPI for the rendering provider.
  • DME suppliers must use the Type 2 NPI for the specific location.
  • Labs and other ancillary providers must use Type 2 NPI for the entity.
  • Facilities must use the Type 2 NPI number.

** The NPI guidelines were established to help support and clarify the use of NPI numbers when inquiring about eligibility and benefits as well as claim adjustments for BCBSTX members.

Webinars

To request one-on-one training email us. Please include your name and telephone number.

Caller Guides

 

* Providers who do not have an NPI or are calling from out-of-state may speak or enter their tax ID number (TIN) when prompted by the IVR; however, these providers must specify their provider type, specialty and network status to receive a quote of benefits.

** The NPI guidelines were established to help support and clarify the use of NPI numbers when inquiring about eligibility and benefits as well as claim adjustments for BCBSTX members.