New Location for Utilization Management on Provider Website

May 19, 2021

Utilization Management information, which includes Prior Authorizations, is now located under Claims and Eligibility on the Blue Cross and Blue Shield of Texas (BCBSTX) provider website. This change was designed to enhance your experience for the entire claim cycle from the moment a member walks into your office, from reviewing prior authorization requirements to processing claims for covered services you provide.

Be sure to bookmark the new location for Utilization Management which includes:

  • Explanations of utilization management reviews
  • Links to tools to manage utilization management reviews
  • Links to predetermination and prior authorization code lists

If you have questions, contact your Network Management Representative.