April 15, 2020
As previously announced Feb. 19, starting June 1, 2020, Blue Cross and Blue Shield of Texas (BCBSTX) will administer behavioral health benefits for members enrolled in our Blue EssentialsSM, Blue Essentials AccessSM, Blue PremierSM and Blue Premier AccessSM provider networks. Magellan Healthcare® will no longer administer behavioral health benefits for these members.
In addition, behavioral health services for HealthSelect of Texas and Consumer Directed HealthSelectSM (HealthSelect) participants will transition from Magellan to BCBSTX effective Sept. 1, 2020.
How Does This Affect You?
For care of Blue Essentials and Blue Premier members on or after June 1 and HealthSelect participants on or after Sept. 1:
- Direct eligibility and claims inquiries to BCBSTX. Please call the number on the member’s ID card.
- Obtain prior authorizations online using Availity® Authorizations & Referrals or call the number on the member’s ID card.
- Submit behavioral health claims to BCBSTX for reimbursement.
- For these members to receive in-network benefits, you must be in our Blue Essentials or Blue Premier provider networks. HealthSelect of Texas and Consumer Directed HealthSelect plans use the Blue Essentials provider network.
- For more information, refer to the Behavioral Health Changes FAQs.
It’s important to use the Availity Provider Portal or your preferred vendor to check eligibility and benefits for our members before rendering services. This will help you confirm coverage details and prior authorization requirements and determine if you are in-network for the member’s policy. Refer to Eligibility and Benefits for details.
How Does This Affect Members?
We do not expect member benefits to be affected by this change. Members will be notified of the change before their transition date, and some members will receive new BCBSTX ID cards.
If you have questions or would like information about joining our networks, contact your local Network Management Representative. Information also is available on the Network Participation page.
Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. Aerial and Medecision® are trademarks of Medecision, Inc., a separate company that offers collaborative health care management solutions for payers and providers. BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by Availity or Medecision. The vendors are solely responsible for the products or services they offer. If you have any questions regarding any of the products or services they offer, you should contact the vendor(s) directly.