Inpatient Services Require Preauthorization

September 13, 2018

Reminder: Inpatient services for Blue Cross and Blue Shield of Texas (BCBSTX) members require preauthorization approval prior to services being rendered. Obtaining preauthorization approval is the responsibility of participating providers.

To obtain preauthorization for inpatient services through BCBSTX:

  • Use iExchange® Learn more about third-party links. This online tool is accessible to physicians, professional providers and facilities contracted with BCBSTX.
  • For more information or to set up a new account, refer to the iExchange page in the Provider Tools section of our Provider website.

Services performed without benefit preauthorization may be denied in whole or in part for payment and you may not seek any reimbursement from the member. For any service not approved for payment, BCBSTX will provide all appropriate appeal rights for review. Providers should refer to the Preauthorizations/Notifications/Referral Requirements Lists posted on the provider website for current lists of services that require preauthorization.

NOTE: The Preauthorization requirement also applies to Out of Area Members and obtaining preauthorization approval is the responsibility of participating providers.

If you have any further questions, contact your Network Management Representative.