| October 19, 2012 For Travis Service-Area Medicaid & CHIP Providers Welcome to the Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid (STAR) & CHIP weekly newsletter. Thank you for participating in BCBSTX Medicaid (STAR) & CHIP programs.
Upcoming Training
Do you know:
- How to obtain 17P (Alpha Hydroxy Progesterone) for your providers' office and billing requirements?
- What labs to use for the First Trimester Down Syndrome Test for BCBSTX Medicaid (STAR) and CHIP members?
- The number of postpartum visits covered for members?
- How your patients can access free prenatal classes, become eligible for a free infant car seat, breast pump and access other great services and benefits?
| OB/GYN's, pediatricians and family practice offices may join BCBSTX Medicaid (STAR) and CHIP Provider Network Representatives for an educational seminar/webinar. There will be a Q&A section and the Provider Network Representatives will be available to answer your questions. There will be games and prizes as well as a surprise mystery guest! All physician office staff members are encouraged to attend: Front office staff, billing and coding staff, clinical staff and physicians will all receive valuable information regarding general, newborn claims billing as well as OB/GYN-specific information regarding the BCBSTX Medicaid (STAR) and CHIP program that will greatly benefit your office. The event takes place Oct. 25, Noon to 2 p.m. There are two ways to attend the event: 1. Live Seminar at Central Texas OB/GYN Associates, 7718 Wood Hollow Dr, Suite 100, Austin, TX 78731
RSVP: Space is limited at the live seminar, so please RSVP to juanita_hill@bcbstx.com or call 512-349-4896 by Oct. 23. Lunch will be provided for Live Seminar attendees and all attendees will have the opportunity to play games and win prizes. | 2. Webinar
Dial-in Attendance Information
Step 1: Dial into the conference call at 866-308-0254. The passcode is 2142100850#.
Step 2: Log into the Live Meeting webinar at https://www.livemeeting.com/cc/wellpointinc/join?id=BCBSTPT&role=attend&pw=BCBST+Provider.
Click on the “Join Meeting” button. |
Unattested NPIs
BCBSTX will deny claims with an unattested NPI, even if you provide legacy information. Attestation is the process of registering and reporting your NPI with your state Medicaid agency. Providers serving Texas Medicaid patients are required to register and attest their NPI with the state of Texas Medicaid & Healthcare Partnership (TMHP). You can attest your NPIs on the TMHP website at http://www.tmhp.com.
Questions about Claims
If you have questions about claims status or how to file a claim, including how to complete claims forms, please contact the Customer Care Center at 888-292-4487.
Electronic Claims
BCBSTX cannot be responsible for claims never received. You must work with vendors to help ensure files are successfully submitted to BCBSTX. Failure of a third party to submit a claim to BCBSTX may risk your claim being denied for untimely filing if those claims are not successfully submitted during the filing limit.
After submitting electronics claims, do the following:
- Monitor claim status by calling the Customer Care Center at 888-292-4487 or through the Interactive Voice Response (IVR).
- Watch for (and confirm) plan Batch Status Reports from your vendor/clearinghouse to help ensure your claims have been accepted by BCBSTX.
- You can correct and resubmit Batch Status Reports and error reports electronically.
- Correct any errors and resubmit (electronically) immediately to prevent denials due to untimely filing.
| In Network Labs
BCBSTX Medicaid (STAR) & CHIP is currently contracted with Clinical Pathology Labs and Quest Laboratory.
http://public.hcsc.net/providerfinder/medicaid-search.do?corpEntCd=TX1
Administrative Issues Contact Information
Submit paper claims to:
Blue Cross and Blue Shield of Texas
Attn: Claims
P.O. Box 684787
Austin, TX 78768 - 4787 | Provider Complaints
Blue Cross and Blue Shield of Texas
Attn: Complaints and Appeals Department
P.O. Box 684249
Austin, TX 78768 - 4787 | Provider Appeals
Submit an appeal in writing using the Provider Dispute Resolution Form. Submit within 120 calendar days from receipt of the Remittance Advice (RA) or notice of action letter. The Provider Dispute Resolution Form is located at http://bcbstx.com/provider/pdf/provider_dispute.pdf.
Blue Cross and Blue Shield of Texas
Attn: Complaints and Appeals Department
P.O. Box 684249
Austin, TX 78768 | External Review
The Provider may request an external review from a non-network provider of the same or related specialty. The provider must submit the request in writing to the below address:
Blue Cross and Blue Shield of Texas
Attn: Complaints and Appeals Department
P.O. Box 684249
Austin, TX 78768 |
Link to BCBSTX Medicaid Website
On this website, you will find links to the Provider Manual, Quick Reference Guide, Services Requiring Prior Authorization, and other useful information.
http://bcbstx.com/provider/network/medicaid.html
Contact Us
Provider Customer Service: 888-292-4487, 7 a.m. to 6 p.m. CT, Monday through Friday
For general questions and concerns:
Jamye Rushing, jamye_rushing@bcbstx.com, 512-349-4876; Fax: 512-349-4848 Network Provider Representatives
Juanita Hill, juanita_hill@bcbstx.com, 512-349-4896
Burnet, Williamson, Blanco, Lampasas, Llano, San Saba Shelby Robinson, shelby_robinson@bcbstx.com, 512-349-4897
Lee, Austin County, Bell, Burleson, Milam, Washington Britton Thibodeaux, britton_thibodeaux@bcbstx.com, 512-349-4898
Bastrop, Caldwell, Fayette, Hays, Colorado, Comal, Gonzales, Guadalupe, Lavaca Dee Culver, deanna_culver@bcbstx.com, 512-349-4899
Travis Clinical Outreach & Education, Quality/Compliance
Kathy Clark, kathy.clark@wellpoint.com, 512-349-4480 Senior Outreach Specialist/Member Advocate
Sonia Saenz, sonia.saenz@wellpoint.com, 512-349-4883 |
