April 20, 2020
In response to COVID-19, the iExchange deactivation planned for April 15, 2020, has been temporarily suspended to allow you additional time to convert to the Availity® Authorizations & Referrals tool during this pandemic.
Given the iExchange extension is only temporary, you are still encouraged to transition to the Availity Authorizations & Referrals tool for electronic prior authorization submissions for inpatient admissions, select outpatient services and referral requests handled by Blue Cross and Blue Shield of Texas (BCBSTX).
- Medical and surgical predetermination of benefits requests may be submitted via iExchange during this extension or by fax or mail by using the Predetermination Request Form.
- Check the patient's eligibility and benefits first to determine if prior authorization is required for the service and/or procedure code. For online assistance, refer to the General Eligibility and Benefits Expanded Tip Sheet.
- If you haven't registered with Availity, you can sign up for free on the Availity website . For help, contact Availity Client Services at 800-282-4548.
- The process of submitting prior authorization requests through eviCore healthcare (eviCore) or other vendors has not changed.
For More Information
Refer to the educational Availity Authorizations User Guide and Availity Referrals User Guide located under the Provider Tools section of our website.
BCBSTX is offering additional weekly webinars for you to learn more about the Availity Authorizations & Referrals tool. Visit our Educational Webinar/Workshop page to register for an upcoming session. If you need further assistance or customized training, contact our Provider Education Consultants.
Please note that the fact that a service has been preauthorized/pre-notified is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member's eligibility and the terms of the member's certificate of coverage applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX.
iExchange is a trademark of Medecision, Inc., a separate company that provides collaborative health care management solutions for payers and providers.
eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSTX. eviCore is wholly responsible for its own products and services. BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity, eviCore or Medecision.
If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.