Code-Auditing Enhancement

August 14, 2017

Effective Nov. 12, 2017, Blue Cross Blue Shield of Texas (BCBSTX) will be implementing an enhancement to the Verscend ConVergence Point code-auditing software*. This software enhancement will help improve auditing of professional and outpatient facility claims that are submitted to BCBSTX by clinically validating modifiers submitted on such claims.

Upon implementation of the code-auditing enhancement, providers may use the Claim Research Tool (CRT), available on the AvailityTM Web Portal. The CRT offers enhanced, real-time claim status functionality, along with detailed ineligible reason codes descriptions.

For additional information, watch the Blue Review, as well as the News and Updates section of our Provider website.

*The above notice does not apply to government programs claims.

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 any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.

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