Alacura Medical Transportation Management, LLC manages air and ground medical transportation, utilization, prior authorization, recommended clinical review and retrospective claim reviews for fully insured members and certain Administrative Services Only groups, effective Jan. 1, 2025.
Alacura manages:
- Air (interfacility transfer for both fixed wing and rotor flights)
- Ground (reviewing level of care from basic life support to advance life support and urgency level for emergency and non-emergency transportation)
- Simple workflows and administrative processes to help locate available ambulances, beds at the receiving hospital and other patient transport logistics
- Assurance that members are transported by an in-network provider where possible while proving cost effectiveness of member benefits
Alacura does not manage:
- Services for members with Medicare Advantage or Medicaid benefit plans
- 911, scene of accident or residence-based pickups
Prior authorization and recommended clinical review
Refer to utilization management for information and lists of codes that may require prior authorization or services applicable to recommended clinical review.
Submitting requests to Alacura
Once a transport decision is made, contact Alacura immediately. Ensure you have all the following before requesting prior authorization or recommended clinical review from Alacura:
- Your name, callback number, unit from which you’re calling
- Sending hospital name, receiving hospital name
- Patient name, date of birth, member ID
- Diagnosis of patient, overall condition and reason for transfer
- When are you wanting to transfer
For BlueCard® members (members of Blues Plans other than Texas), contact the phone number on the member ID card to determine if prior authorization with Alacura is needed.
Ambulance providers
Ensure Alacura has been engaged for patient transports from facilities before picking up the patient. This will let you know if the transport is approved. Nurses are available 24/7/365 for real-time verbal assessments.
Alacura contacts
Check eligibility and benefits
Check eligibility and benefits through Availity® Essentials or your preferred vendor. This may also indicate if a service requires a prior authorization, recommended clinical review or retrospective review.
Alacura Medical Transportation Management, LLC, is an independent company that has contracted with Blue Cross and Blue Shield of Texas to provide utilization management services for members with coverage through BCBSTX.
Prior authorization determines whether the proposed service or treatment meets the definition of medical necessity under the applicable benefit plan.
Checking eligibility and benefits information, and/or the fact that any pre-service review has been conducted, is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member's certificate of coverage applicable on the date services were rendered.
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 third party vendors and the products and services they offer.