-
- Home
- Network Participation
Network Participation
- Claims and Eligibility
- Education and Reference Center
- Clinical Resources
Clinical Resources
- Clinical Resources
- Alacura Medical Transportation Management
- Carelon
- Clinical Practice Guidelines
- eviCore Prior Authorization Program
-
Health Equity and Social Determinants of Health (SDoH)
- Opioid Resources
- Preventive Care Guidelines/Patient Wellness Guidelines
-
Quality Care – Partner With Your Patients
- Quality Improvement Tip Sheet
- Special Beginnings - Maternity Program
- Telemedicine and Telehealth Services
- Behavioral Health Care Management Program
- Pharmacy Program
- Standards and Requirements
Standards and Requirements
- Standards and Requirements
-
Affordable Care Act (ACA)
- Clinical Payment and Coding Policies
-
Consolidated Appropriations Act and Transparency in Coverage Final Rule
-
Disclosure Notices
- Federal Employee Program (FEP)
-
General Reimbursement Information
-
Manuals
- Medical Policies
- Medical Policy and Pre-certification/Pre-authorization Information for Out-of-Area Members
- PEAQ - Physician Efficiency, Appropriateness, & Quality Program
- Employers
- Producers
- Providers
- Company Information
Get updates in your inbox
Sign up for our monthly Blue ReviewSM for news on billing, utilization management and more.
You can also follow the latest in News and Updates.
Eligibility, authorizations and claims
Review resources to help you manage claims, payments and utilization management reviews.
Do business in Availity® Essentials
Availity is a one-stop shop. You can submit claims, check patient benefits and eligibility, get authorizations and more.
See online tools in Availity that make doing business easier.
If you don’t yet have an account, register here at no cost to you.
Medicare Advantage and Medicaid
Review credentialing, claims, requirements and resources for:
• Blue Cross Medicare Advantage (PPO)SM
• Blue Cross Medicare Advantage (HMO)SM and Blue Cross Medicare Advantage Dual Care (HMO SNP)SM
• Medicaid
ERS and TRS
See benefit plans and resources for:
• Employees Retirement System of Texas, and
• Teacher Retirement System of Texas
Resources
Join our statewide network
When you enroll, you’ll be a partner in our commitment to delivering access to quality, cost-effective care for our members.
Provider directory
Search for doctors, hospitals, urgent care and other health care providers.
BlueCard® Program
Submit claims for members with other Blue Cross and Blue Shield Plans to us through this national program.