08/21/2024
Blue Cross Blue Shield of Texas has changed the reimbursement for out-of-network urgent and emergent providers servicing our BlueHPN® members. Effective August 18, 2024, we implemented a claim system coding change to reimburse out of network urgent & emergent providers at new non-contracted rates (100% of Medicare in most cases) for BlueHPN members.
What should I do?
Check Eligibility and Benefits: To identify if a service requires prior authorization for our members, check eligibility and benefits through Availity® or your preferred vendor.
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.