-
- Home
- Network Participation
Network Participation
- Claims and Eligibility
Claims and Eligibility
- Claims and Eligibility
- BlueCard Program
-
Electronic Commerce
- Eligibility and Benefits
-
Utilization Management
- Prior Authorization Services For Fully Insured and ASO
- Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO)
- Prior Authorizations Lists for Designated Groups
- Recommended Clinical Review Option
- Prior Authorization Exemptions (Texas House Bill 3459)
-
Claims Filing Tips
- Claim Status
- Claim Review Process
- Interactive Voice Response (IVR) System
- Education and Reference Center
- Clinical Resources
Clinical Resources
- Clinical Resources
- Alacura Medical Transportation Utilization Management, Inc.
- Behavioral Health Care Management Program
- Carelon
- Clinical Practice Guidelines
-
Quality Care – Partner With Your Patients
- eviCore Prior Authorization Program
- Special Beginnings - Maternity Program
- Preventive Care Guidelines/Patient Wellness Guidelines
- Quality Improvement Tip Sheet
- Telemedicine and Telehealth Services
-
Health Equity and Social Determinants of Health (SDoH)
- 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
Employees Retirement System of Texas (ERS)
HealthSelect of Texas® & Consumer Directed HealthSelectSM
Teacher Retirement System of Texas (TRS)
TRS-ActiveCare Primary
TRS-ActiveCare Primary+
TRS-ActiveCare HD
TRS-ActiveCare 2
TRS-Care Standard
Learn about our PPO and HMO Networks and Plans
Use our Provider Tools via Availity® Essentials and attend training sessions
Reference our Provider Manuals
Resources
Blue Review
Stay informed about BCBSTX programs, products, initiatives, and more.
Sign up to receive the monthly Blue Review via email.
Update Your Information
Keep your information up to date by reporting changes in your address, telephone number, tax ID number and more. Provide your email address to get our Blue Review newsletter electronically!
Policies
Medical and pharmaceutical policies help determine benefits coverage. Explore policies and drafts in process.
Provider Finder®
Search for doctors, dentists, hospitals and other health care providers.
Training Opportunities
Register for workshops and webinars to take full advantage of our online services.