Service Coordination

Service coordinators assists you and your child in coordinating acute and long-term care services. They will also help you choose the providers that your child needs. If you prefer to see a Medicaid doctor who is not part of our network, you will need to work with a service coordinator so arrangements will be made for authorizations for your child's out-of-network provider.

All members receiving long-term services and supports, or those who request them will receive Service Coordination services from Blue Cross and Blue Shield of Texas (BCBSTX) STAR Kids. These services include private duty nursing (PDN) and personal care services (PCS). You and your BCBSTX service coordinator will work together to:

  • Assess your health and mental needs
  • Create a care plan to help you set health care goals for your child
  • Organize all your services
  • Monitor progress toward your health care goals

Your BCBSTX service coordinator will:

  • Call you and get to know you and your health care, long-term care and behavioral health needs
  • Help coordinate your care with any other service coordinators , doctors, pharmacists or people who are important for your care needs
  • Help you find services that are not normal Medicaid benefits

These services can include getting needed community support and services such as:

  • Setting up transportation
  • Home health nursing
  • Private duty nursing
  • Pediatric extended care services
  • Physical or Occupational therapy
  • Speech therapy 
  • Medical supplies
  • Durable Medical Equipment (DME)
  • Personal Care Services
  • Resources for Special Health Care individual needs
  • Food or electricity Community Resources
  • Behavioral Health referrals
  • Disease Management Coordination
  • Care Giver support and resources

How to Get Other Services

To learn more about BCBSTX STAR Kids covered programs and services, or for help finding a specialist, substance abuse services, or an OB/GYN provider, call the Customer Advocate Department at 1-877-688-1811 (TTY: 711) from 8 a.m. to 5 p.m. CT, Monday through Friday. You may also leave a voicemail outside of our normal business hours or on weekends and holidays.

Find more information about your child's assigned service coordinator by logging in to Blue Access for MembersSM (BAM). In BAM, you can find the service coordinator's name, phone number, and email address. You can also check their most recently completed Screening and Assessment Instrument (SAI) or Individual Service Plan (ISP). Learn more about the SAI. You can also find out more about the state requirements for the SAI.

You will also get your service coordinator's name and phone number in the mail. You can call your BCBSTX service coordinator at 1-877-301-4394 or by calling the Customer Advocate Department at 1-877-688-1811.

To learn more, check the Service Coordination brochure or the Member Handbook.

Learn How Your Plan Works

To learn more about Service Coordination, see the Member Handbook

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