• Welcome
  • Employers
  • Producers
  • Providers
  • Company Information
  • Contact Us
  • Language Assistance
Blue Cross and Blue Shield of Texas Logo
Blue Cross and Blue Shield of Texas Logo
  • icon home
  • Home
  • Network Participation

    Network Participation

    • Network Participation
    • How to Join Our Networks
    • Update Your Information
    • Change of Ownership
  • Claims and Eligibility

    Claims and Eligibility

    • Claims and Eligibility
    • BlueCard Program
    • Electronic Commerce
    • Eligibility and Benefits
    • Utilization Management
      • Prior Authorization Services For Fully Insured and ASO
      • Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO)
      • Prior Authorizations Lists for Designated Groups
      • Recommended Clinical Review Option
      • Prior Authorization Exemptions (Texas House Bill 3459)
    • Claims Filing Tips
    • Claim Status
    • Claim Review Process
    • Interactive Voice Response (IVR) System
    • Medicare Advantage Private Fee-for-Service (PFFS)
    • Eligibility and Benefits Inquiry (HIPAA 270/271)
  • Education and Reference Center

    Education and Reference

    • Education and Reference Center
    • Blue Review
      • 2022 BR Archive
    • ERS Tools
    • TRS Tools
    • Forms
    • Identification Cards
    • Manuals
    • News and Updates
      • 2023 News and Updates
    • Provider Tools
    • Provider Training
    • Blue Review Archive
    • UTS -Tools
  • Clinical Resources

    Clinical Resources

    • Carelon (formerly AIM) Effective March 1, 2023
    • Clinical Resources
    • Behavioral Health Care Management Program
    • Clinical Practice Guidelines
    • Quality Care – Partner With Your Patients
    • eviCore Prior Authorization Program
    • Special Beginnings - Maternity Program
    • Preventive Care Guidelines/Patient Wellness Guidelines
    • Quality Improvement Tip Sheet
    • Telemedicine and Telehealth Services
    • Health Equity and Social Determinants of Health (SDoH)
  • Pharmacy Program

    Pharmacy Program

    • Pharmacy Program
    • Dispensing (Quantity vs. Time) Limits
    • Medicare Part D Pharmacy Updates
    • Prescription Drug List and Prescribing Guidelines
    • Specialty Pharmacy Programs
    • Prior Authorization and Step Therapy Programs
    • Split Fill Program
  • Standards and Requirements

    Standards and Requirements

    • Standards and Requirements
    • Affordable Care Act (ACA)
    • Clinical Payment and Coding Policies
    • Disclosure Notices
    • Federal Employee Program (FEP)
    • General Reimbursement Information
    • Manuals
    • Medical Policies
    • Medical Policy and Pre-certification/Pre-authorization Information for Out-of-Area Members
    • Consolidated Appropriations Act and Transparency in Coverage Final Rule
  • Employers
  • Producers
  • Providers
  • Company Information

Teacher Retirement System of Texas (TRS) — Behavioral Health Forms

Form Description

Applied Behavior Analysis (ABA) forms:

  • TRS ABA Clinical Service Request Form
  • TRS ABA Initial Assessment Request
  • Supervision via Telehealth Request — Attestation
 

Coordination of Care

 

TRS Electroconvulsive Therapy (ECT) Request

 

TRS Intensive Outpatient Program (IOP) Request

 

TRS Repetitive Transcranial Magnetic Stimulation (rTMS)

 

 

Insurance Basics


  • Health Care Costs
  • Types of Health Insurance Coverage
  • Glossary
  • FAQs

Buying a Health Plan


  • How to Enroll for Health Insurance
  • Get a Quote/Browse and Buy Plans
  • Premium Tax Credit Estimator
  • Individual & Family Plans
  • Medicare Plans

Member Resources


  • Log in to Blue Access for Members
  • Register for Blue Access for Members
  • Pay My Bill
  • Federal Employee Program (FEP)
Blue Cross and Blue Shield of TX FacebookBlue Cross and Blue Shield of TX TwitterBlue Cross and Blue Shield of TX  YouTubeBlue Cross and Blue Shield of TX ConnectBlue Cross and Blue Shield of TX LinkedIn
 
  • Legal and Privacy
  • Non-Discrimination Notice
  • Careers
  • Contact Us
  • Newsroom
 

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association


© Copyright 2022 Health Care Service Corporation. All Rights Reserved.

 

PDF File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in reader. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com

 

External link You are leaving this website/app (“site”). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. In addition, some sites may require you to agree to their terms of use and privacy policy.