See New Enhancements for Behavioral Health Prior Authorizations Effective Nov. 6, 2023

Posted 8/3/2023 Updated 10/19/23

Blue Cross and Blue Shield of Texas (BCBSTX) is continuing to make enhancements to its behavioral health (BH) prior authorization review process for some commercial members.

When submitting requests for BH reviews the best method is to submit the request electronically via Availity Authorizations and Referrals.

Here’s what’s new: effective Nov. 6, 2023, if you are unable to submit a request electronically through Availity, call the number on the member ID card and use the interactive voice response (IVR) system to complete a real-time review with customer service and a live clinician.

Beginning Nov. 6, you will be able to use the IVR system, as well as the forms, to request Inpatient, Residential and Partial Hospitalization services, including these outpatient services: Intensive Outpatient Program (IOP), Electroconvulsive Therapy (ECT) and Repetitive Transcranial Magnetic Stimulation (TMS).                                                                                                   

More Information: watch News and Updates for future announcements on behavioral health.

Checking eligibility and/or benefit information and/or obtaining prior authorization 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, including, but not limited to, exclusions and limitations 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. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.