12/30/2024 Review of Rescinded Prior Authorization Exemptions
12/24/2024 Removal of Dermatology Referral Requirement for HealthSelect of Texas Effective 01/01/2025
12/18/2024 Records Needed to Support Quality Care for Medicare Advantage Members
12/18/2024 CPCP006 Preventive Services Policy Updated Effective 01/01/2025
12/18/2024 Medical Records Collection for Federal Employee Program® Begins in February
12/18/2024 Ensure Your Office Is Providing Your Most Current Information
12/17/2024 Annual Review: CPCP027 Inpatient Readmissions Updated
12/16/2024 Remind Billing Agencies to Correctly Submit Claim Review Requests
12/13/2024 Follow-Up Care Is Recommended for Children Prescribed ADHD Medication
12/11/2024 2025 Holiday Schedule Reminders for E-Commerce
12/10/2024 Remind Our Members about Cervical and Breast Cancer Screenings
12/09/2024 Solutions and Results Monitoring for Gene Therapy Treatments to Launch in 2025
12/09/2024 Update Your Records for New Blue Cross Group Medicare Advantage Open Access (PPO)SM Members
12/09/2024 CMS Tracks High-Risk Medication Combinations with New Part D Quality Measures
12/06/2024 Keep Your Contact Information Updated to Receive Recredentialing Reminders
12/03/2024 Updated Lab Management Clinical Payment and Coding Policies for Certain ASO Groups
12/03/2024 Comparing Commercial and Retail BCBSTX Member Satisfaction with Providers
11/27/2024 Funds to Be Recouped on Some Medicare Advantage Hospital and Ancillary Claims
11/26/2024 Coding Reference for Quality Measures Is Available to Help Identify Gaps in Care
11/25/2024 Preferred Drugs to be Recommended Through Enhanced Prior Authorization
11/25/2024 ClaimsXten™ Quarterly Update Effective March 17, 2025
11/13/2024 Reminder: Medical Transportation Utilization Management Via Alacura Effective Jan. 1, 2025
11/13/2024 Annual Review: CPCP029 Medical Record Documentation Updated
11/12/2024 Follow CMS Guidelines for Appointment Wait Time Standards
11/12/2024 CPCP036 Paravertebral Facet Injection Procedure Billing & Coding Policy Updated Effective 02/13/2025
11/12/2024 CPCP008 Psychological and Neuropsychological Testing Updated Effective 02/13/2025
11/12/2024 CPCP020 Drug Testing Clinical Payment and Coding Policy Updated Effective 02/13/2025
11/07/2024 SmartRx Assist® Changes Its Name to HelpScript
11/04/2024 Update: Select Self-Administered Drugs Moving to Pharmacy Benefit Effective March 1, 2025
11/04/2024 How to Submit Photos to Accompany Prior Authorization or Recommended Clinical Review Requests
11/01/2024 Medical Transportation Utilization Management for Some Members Updated Effective Jan. 1, 2025 (Updated)
11/01/2024 Pharmacy Program Quarterly Update Changes Effective Jan. 1 2025 – Part 1
10/31/2024 Prior Authorization Code Updates for Medicare Advantage Members Effective January 1, 2025
10/30/2024 Select Self-Administered Drugs Moving to Pharmacy Benefit Effective Jan. 1, 2025 - Note: see 01/13/2025 - Effective date change to 03/15/2025
10/29/2024 CPCP011 Applied Behavior Analysis – Effective 02/01/2025
10/28/2024 Check ID Cards for New Coupe Health Plan Members (Updated)
10/25/2024 Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
10/24/2024 Talk to Our Members About the Flu Vaccine
10/23/2024 Encourage Annual Eye Exams for Our Members with Diabetes
10/23/2024 Statin Therapy Is Recommended for Patients with Cardiovascular Disease and Diabetes
10/15/2024 Medicare Prescription Payment Plan Launching Jan. 1, 2025
10/15/2024 MyBlue HealthSM Network Expansion Effective Jan. 1, 2025
10/11/2024 Important Benefit Changes For Fully Insured Texas Group Plans (Revised from 10/1/2024)
10/09/2024 Risk Identification and Outreach Program Supports Member Safety
10/03/2024 Prior Authorization Code Changes for Commercial Members Effective Jan. 1, 2025
10/03/2024 Additional Claim Processing Enhancements for ERS Plans Effective October 21, 2024 - Updated
10/02/2024 Acquisition of Cigna Healthcare Medicare Business in 2025
10/01/2024 Check ID Cards for New Coupe Health Plan Members
10/01/2024 Important Benefit Changes For Fully Insured Texas Group Plans
09/30/2024 Site of Care Utilization Management Review for Advanced Imaging Effective Jan. 1, 2025
09/30/2024 Medical Transportation Utilization Management for Some Members Updated Effective Jan. 1, 2025
09/30/2024 Updates Coming to Behavioral Health Substance Use Disorder Criteria for Utilization Management
09/30/2024 New Laboratory Claims Review for Certain ASO Groups - Jan. 1, 2025
09/25/2024 CPCP006 Preventive Services Policy Update Effective 10/01/2024
09/24/2024 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 2
09/18/2024 Coordinating Care after Hospital Discharges Can Help Our Members’ Transition
09/10/2024 Register for a Coding Webinar on Coagulation Defects and Other Hematological Disorders
09/09/2024 In-home Test Kits Help Our Members Manage Their Kidney Health
09/06/2024 ClaimsXten™ Quarterly Update Effective Dec. 9, 2024
09/05/2024 Updated Claims Referral Form for American Indian/Alaska Native Limited Cost Share Plans
09/01/2024 Prior Authorization Exemption Notifications for Jan. 1 - June 30, 2024 Review Period
08/28/2024 Annual Review: CPCP035 Unlisted/Not Otherwise Classified (NOC) Coding Policy effective 08/29/2024
08/28/2024 Reminder: Recommended Clinical Review for Outpatient Services Effective Sept. 1 for TRS Participants
08/24/2024 Texas Senate Bill 1040 Prohibits Organ Transplants Associated with China
08/23/2024 Claim Processing Enhancements for ERS Effective Sept. 1, 2024 (Updated)
08/21/2024 Reminder: Update to Recommended Clinical Review Effective Sept. 1, 2024 for ERS Plans
08/21/2024 Out-Of-Network Urgent & Emergent Providers Blue High Performance Network® Reimbursement Update
08/20/2024 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1
08/19/2024 Cancer Prevention Vaccine? The sooner the better!
08/14/2024 Encourage Medicare Members to Respond to Health Outcomes Survey
08/13/2024 Annual Review: CPCP001 Observation Services Policy effective 08/14/2024
08/12/2024 Shared Decision-Making Aids Can Help Guide Care Choices
08/08/2024 Check ID Cards for New Coupe Health Plan Members
08/05/2024 Language Line Supporting Cultural Competence
08/02/2024 Additional Claim Processing Enhancements for ERS Plans Effective October 21, 2024
07/31/2024 Annual Review: CPCP031 - Trauma Activation- Facility Services Updated Effective 08/01/2024
07/31/2024 Abiraterone Drug Coverage Changes Coming for Many Commercial Members
07/26/2024 Prior Authorization Code Updates for Medicare Advantage Members, Effective Oct. 1, 2024
07/23/2024 Physician Performance Insights Reports Are Now Available
07/19/2024 Speaking Out About the ‘Silent Killer’
07/17/2024 Provider Depression Disorder Prescribing
07/17/2024 Has Your Information Changed? Update Us and the NPI Registry
07/16/2024 Provider Finder® Ranks Providers to Help PPO Members Find Care
07/15/2024 Annual Review: CPCP041 Sepsis Policy Updated Effective 07/16/2024
07/12/2024 Medicare Providers May Treat Blue Cross Group Medicare Advantage Open Access (PPO)SM Members
07/10/2024 Annual Review: CPCP021 Laboratory Panel Billing Updated Effective 07/11/2024
07/09/2024 CPCP012 Hernia Repair Updated Effective 10/10/2024
07/09/2024 Earn Continuing Education Credit: Webinar on Avoiding Inappropriate Antibiotic Use
07/03/2024 Breast Cancer Screening for Members Ages 40 to 74
07/01/2024 2024 Prior Authorization Exemption Renewal Results
07/01/2024 Review of Rescinded Prior Authorization Exemptions
06/27/2024 Prior Authorization Code Changes for Commercial Members Effective Oct. 1
06/27/2024 Pharmacy Program Quarterly Update: Changes Effective July 1, 2024 – Part 2
06/26/2024 CPT Category II Codes Can Help Close Care Gaps
06/24/2024 Annual Review: CPCP034 Unbundling Policy-Professional Providers Updated Effective June 25, 2024
06/24/2024 Proper Billing for Supplies for Transcutaneous Electrical Nerve Stimulation Units
06/21/2024 NICU Utilization Management Update Effective Sept. 1, 2024, for ERS Plans
06/20/2024 CPCP006 Preventive Services Policy Update Effective 07/01/2024
06/20/2024 Coming Soon – New Learning & Training Center in Availity® Essentials
06/18/2024 Provider Rights and Responsibilities
06/18/2024 Member Rights and Responsibilities
06/20/2024 New Coupe Health Plan: Update Your Member Records
06/10/2024 Encourage Routine Vaccines and Well-Care Visits for Children and Teens
06/07/2024 GLP-1 New to Therapy Optional Benefit Program Available for Select Commercial Members
06/07/2024 In-Home Test Kits for Colorectal Cancer Screening
06/05/2024 TXCPCP03 Surgical and Non-Surgical Services Updated Effective 09/06/2024
05/31/2024 Changing Prior Authorization to Recommended Clinical Review Effective Sept. 1 for TRS Participants
05/31/2024 Prime Therapeutics Drug Claims Processed in Error Without Required Prior Authorization
05/29/2024 Updated PEAQSM Methodology Is Now Available
05/28/2024 Claim Processing Enhancements for ERS Effective Sept. 1, 2024
05/20/2024 Access MCG Care Guidelines Clinical Criteria via Availity®
05/20/2024 Physician Performance Insights Coming Soon from PEAQSM
05/15/2024 The Need for Better, Improved Continuity and Coordination of Care
05/15/2024 ClaimsXten™ Quarterly Update Effective Aug. 19, 2024
05/13/2024 Closing Gaps in Care for Group Medicare Advantage (PPO) members
05/09/2024 Behavioral Health Consultations During Medical Hospitalization Can Improve Outcomes
05/09/2024 Helping Our Members Manage Diabetes
05/07/2024 Pharmacy Program Quarterly Update: Changes Effective July 1, 2024 – Part 1
04/30/2024 PeriPAN Perinatal Mental Health Toolkit for Obstetric Clinicians
04/29/2024 Electronic Claim Review and Ensuring the Correct Use of our Claim Review Form
04/24/2024 Annual Review: CPCP036 Paravertebral Facet Injection Procedure Coding & Billing Policy Updated
04/23/2024 Annual Review: CPCP005 Home Health Care/Private Duty Nursing Policy Updated
04/23/2024 CPCP029 Medical Record Documentation Updated Effective 07/24/2024
04/19/2024 Annual Review: CPCP019 Home Infusion Updated
04/18/2024 Important Updates to Manage My Organization in Availity® Essentials
04/17/2024 Prior Authorization Code Updates for Medicare Advantage Members, Effective July 1, 2024
04/10/2024 BCBSTX 2023 Marketplace Member Satisfaction with Providers Results
04/08/2024 Supporting Maternal Quality Care
04/04/2024 Filing Claims for Behavioral Health Services – Use the Correct Place of Service Code
03/29/2024 Prior Authorization Code Changes for Commercial Members Effective July 1, 2024
03/29/2024 Pharmacy Program Quarterly Update: Changes Effective Apr. 1, 2024 – Part 2
03/28/2024 ImmTrac2: Shot Records in One Secure Place
03/28/2024 CPCP025 Corrected Claim Submission Updated Including Changes for Late/Added Charges
03/26/2024 CPCP006 Preventive Services Policy Update Effective 04/01/2024
03/13/2024 Webinar on Coding for Medicare Advantage Annual Wellness Visits
03/13/2024 Caring for Substance Use Disorders
03/12/2024 Continuity and Coordination of Eye Care
03/12/2024 Recommended Clinical Review Services and Code List Changes for Certain Members
03/11/2024 Earn Continuing Education Credit: Webinar on Substance Use Disorder
03/07/2024 ClaimsXten™ Quarterly Update Effective June 17, 2024
03/05/2024 Annual Review: CPCP002 Inpatient/Outpatient Unbundling Policy- Facility Updated Effective 03/06/2024
03/04/2024 Change Healthcare Cybersecurity Incident Impact and Options
03/04/2024 Annual Review: CPCP017 Wasted/Discarded Drugs and Biologicals Policy Updated Effective 03/05/2024
02/29/2024 Notifications for Prior Authorization Exemptions for July 1 to Dec. 31, 2023 Review Period
02/29/2024 CPCP033 Telemedicine and Telehealth/Virtual Health Care Services Policy Updated Effective 05/01/2024
02/28/2024 See New Effective Date for Claim Editing Changes for Facility Emergency Department Services
02/26/2024 Earn Continuing Education Credit: Webinar on Social Determinants of Mental Health Care
02/23/2024 Annual Review: CPCP022 Pneumatic Compression Devices – Outpatient Use Updated
02/21/2024 Annual Review: CPCP038 Outpatient Services Prior to an Inpatient Admission Updated
02/20/2024 Pharmacy Program Quarterly Update: Changes Effective Apr. 1, 2024 – Part 1
02/20/2024 30-Day Facility Readmission Reviews for Medicare Advantage Members
02/09/2024 Closing Gaps in Colon Care
02/09/2024 Avoiding Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
02/08/2024 Follow-up Care for Mental Health
02/01/2024 Fighting Fraud, Waste and Abuse
01/30/2024 Changes to Claim Inquiry Resolution – High-Dollar, Pre-Pay Reviews Only
01/29/2024 Medicare Advantage HEDIS Records Collection through June 2024
01/29/2024 Reminder: BCBSTX Prior Authorization Exemption Communication Method Preference
01/26/2024 HealthSelect of Texas® In-Area Participants PCP Referral Requirement for In-Network Benefits
01/26/2024 Introducing Smart RxAssist via HealthSmartRx®
01/25/2024 Annual Review: CPCP016 Chiropractic Care Services Updated
01/24/2024 Annual Review: CPCP015 Multiple Surgical Procedures-Professional Provider Services Updated
01/22/2024 Continuing Education Credit Webinar on Pediatric Behavioral Health
01/22/2024 NDC Billing Tool on Our Provider Website is Being Retired
01/19/2023 Annual Review: CPCP014 Global Surgical Package – Professional Providers Updated
01/19/2023 Annual Review: CPCP040 Physical Medicine and Rehabilitation Services Updated
01/18/2024 CPCP023 Modifier Reference Policy Update– Effective 04/19/2023
01/18/2024 Annual Review: CPCP013 Increased Procedural Services (Modifier 22) Updated
01/18/2024 Annual Review: CPCP009 Co-Surgeon/Team Surgeon Modifiers Updated
01/17/2024 Pharmacy Program Quarterly Update, Part 2, Changes Effective January 1, 2024
01/17/2024 Coding Webinars: Major Depressive Disorder and Annual Wellness Visits
01/16/2024 Annual HEDIS/QRS Reports
01/12/2024 Supporting Healthy Hearts
01/11/2024 Prior Authorization Code Updates for Medicare Advantage Members Effective April 1, 2024
01/09/2024 ClaimsXten™ Quarterly Update Effective April 15, 2024
01/08/2024 Update to Prior Authorization Code Changes for Commercial Members Effective April 1, 2024
01/08/2024 Managing Antidepressant Medication
01/03/2024 Federal Employee Program (FEP®) HEDIS® Medical Records Collection February - April 2024