Blue Cross Medicare Advantage Dual Care (HMO SNP)SM

Effective Nov. 1, 2016; if you are located in Burnet, Williamson, Hays, Caldwell, Bastrop, and Lee counties, BCBSTX would like to extend the opportunity to you for participation as a provider in the Blue Cross Medicare Advantage Dual Care (HMO SNP) plan.

BCBSTX was approved to offer, effective Jan. 1, 2017, a Medicare Advantage preferred provider plan that offers improved health benefits for Dual-Eligible Special Needs Plans (D-SNPs) available to qualified beneficiaries who are dually eligible to receive Medicare and Medicaid care through participating providers.

BCBSTX believes that our long standing history in providing affordable health care coverage to the people of Texas, our strong brand recognition, and our historical relationship with Medicare makes BCBSTX an excellent choice for seniors seeking new health coverage opportunities.

BCBSTX needs your network participation for this program to be successful. In order to participate in Blue Cross Medicare Advantage Dual Care (HMO SNP), physicians and professional providers:

  • Must be a participating Blue Essentials (formerly HMO Blue TexasSM) physician or professional provider and a STAR Kids network.
  • Must have privileges at one of the Blue Cross Medicare Advantage HMO participating hospitals (unless inpatient admissions are uncommon or not required for the physician's or professional provider's specialty)
  • Must have a valid National Provider Identifier (NPI) number
  • Must sign a Blue Cross Medicare Advantage HMO amendment to his/her Blue Essentials (formerly HMO Blue Texas) agreement
  • Cannot have opted-out of Medicare or have any sanctions or reprimands by any licensing authority or review organizations

Note: Additional credentialing will not be required for those physicians or professional providers already credentialed in the Blue Essentials (formerly HMO Blue Texas) network and whose re-credentialing is current.

If you have any questions regarding this plan and are interested in participating, please feel free to contact the Austin Network Management office:

BCBSTX Network Management Office Locations

Telephone Numbers

Fax Number

Austin

512-349-4847

512-349-4853

Or go to How to Join BCBSTX Provider Networks and follow the steps.


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