| Q. |
What is available online through this Web site? |
| A. |
You can access information regarding Provider Finder, Medical Policies, Downloadable Forms, Blue Review, iEXCHANGE Online, Pharmacy & Prescribing Guidelines, Wellness Guidelines, General Reimbursement Information, Provider Manuals, Electronic Commerce and Credentialing/Contracting, and The Availity Health Information Network.
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| Q. |
Are the provider fee schedules/reimbursement percentages available on the Web site? |
| A. |
Yes. This information may be located in the Reimbursement Schedules section of the General Reimbursement Information portion of the Web site.
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| Q. |
How do I request the medical policy and/or bundling logic? |
| A. |
Medical policies are available in the Medical Policy section of this site. To request bundling logic, complete the Single Edit Request Form or register with RealMed to access Clear Claim Connection or bundling.
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| Q. |
Can I access iEXCHANGE online for referrals and preauthorizations? |
| A. |
Yes. You will need to sign up for a password on the iEXCHANGE section of this site.
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| Q. |
Where can I get instructions on how to fill out the Physician and Provider Request for Claim Appeal/Reconsideration Review form? |
| A. |
The form and instructions are available on this site under Downloadable forms.
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| Q. |
Can I file appeals online? |
| A. |
Not at this time. However, BCBSTX continuously reviews possible enhancements to our existing processes. Should this option become available in the future, BCBSTX will notify you via our Blue Review newsletter and a notice on our Web site.
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| Q. |
Can you check BCBSTX eligibility if you do not use Availity as your clearinghouse? |
| A. |
Yes. The BCBSTX eligibility and benefit information can be obtained on the Availity web portal even if you use another clearinghouse for your electronic claims. Availity Enrollment Information can be obtained by visiting the Availity Web site at www.availity.com or by clicking on the following link, http://availity.com/register_home.htm.
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| Q. |
Can we go on line to get verifications? |
| A. |
Verification is not currently available online. You will need to call the BCBSTX Provider Customer Service areas for this information.
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| Q. |
Where can I find information on changes and updates within the medical field and with Blue Cross and Blue Shield of Texas? |
| A. |
These can be found in the Blue Review section of our Web site. This section also houses the Blue Review Archives where topics can be searched by issue or subject.
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