11/13/2024
As we previously posted, Alacura Medical Transportation Management will manage prior authorization, recommended clinical review and retrospective claim reviews for air and ground medical transportation on certain fully insured and Administrative Services Only groups* effective Jan. 1.
Alacura will manage:
- Air (Interfacility transfer for both fixed wing and rotor flights)
- Ground (reviewing level of care from basic life support to advance life support and urgency level for emergency and non-emergency transportation)
- Locating available ambulances, beds at the receiving hospital and other logistics of your patient’s transport including transports by an in-network provider when possible.
Refer to our Utilization Management page for links to code lists that require prior authorization or are applicable to RCR for medical transportation.
*Alacura will not manage:
- Members of the fully insured account group #212824
- BCBSTX Medicare Advantage and BCBSTX Medicaid
- 911/scene of accident or residence-based pickups
What do I need to do?
- Register for one of the following training sessions:
- As of Jan. 1, 2025, once the transport decision is made for our member, check eligibility and benefits to determine if Alacura handles medical transportations and notify Alacura if applicable. Ambulance providers can also check with Alacura before picking up the patient to ensure transport will be approved.
Contact Alacura:
- By phone (quickest channel) at 866-671-4834
- By fax at 866-671-4995
- Online at https://alacura.my.site.com/preauth/s/
- By email at Texas.UM@alacura.com
If you have any questions or if you need additional information, please contact your local BCBSTX Network Management Office.
Checking of eligibility and/or benefit information 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, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.
Alacura Medical Transportation Management, LLC. is an independent company that has contracted with Blue Cross and Blue Shield of Texas to provide utilization management services for members with coverage through BCBSTX.
BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.