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Blue Review - Blue Cross and Blue Shield of Texas

November 9, 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.


BCBSTX Medicaid (STAR) and CHIP is hosting a Texas Health Steps Training Event
This event will focus on providing a clinical overview of all the components of Texas Health Steps. We invite billing/administrative staff, clinical staff and physicians to take part in this training. There will be prizes and games at the end of the presentation

Guest Speaker: Deneice Pryor, Provider Representative for Texas Health Steps from the Texas Department of State Health Services - Specialized Health and Social Services will be our guest speaker.

Date and Time: Nov. 15, 2012, Noon to 2 p.m.

Location: BlueCross BlueShield / 9442 Capital of Texas Hwy N / Suite 500, Arboretum Plaza II / Austin, Texas 78759-6839

You can attend this event in two ways:
1.   Live Seminar at the above location. Lunch will be provided for Live Seminar attendees.
RSVP:  juanita_hill@bcbstx.com or call 512-349-4896 by 3 p.m., Nov. 14, 2012

2.   Webinar
Date:  Nov. 15, 2012
Time:  Noon to 2 p.m.
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.


A Message from the Texas Health and Human Services Commission (HHSC)

Texas Women's Health Program Offers Continuity of Care
The Texas Women's Health Program is looking for doctors and physicians with a specialty in family practice, gynecology, OB/GYN, internal medicine or pediatrics who want to help low-income women take control of their futures. You can make a dramatic difference in the lives of women who need the expertise and health services you offer.

"The comments we received from physician groups helped shape the development of the new state program," said Texas Health and Human Services Executive Commissioner Kyle Janek, M.D.  "I encourage physicians to join the Texas Women's Health Program. It's a great way to provide excellent services to low-income Texas women and to your communities."

The women who benefit from this fee-for-service, state-funded program are between 18 and 44 years old. They don't qualify for Medicaid or have health insurance. The Texas Women's Health Program provides them with an annual family planning exam, health screens for things such as diabetes and breast and cervical cancer, treatment for certain sexually transmitted diseases and family planning services such as birth control.

The program offers an opportunity for providers to continue caring for patients whose Medicaid coverage expires after giving birth. Continuity of care is an important aspect of the program for participating doctors, as well as women who want consistency in their family planning and health care.

Any Medicaid provider that offers services covered by the program and complies with the new program rules can enroll as a Texas Women's Health Program provider.

Learn more about enrolling in Medicaid or certifying as a Texas Women's Health Program provider at www.TMHP.com. Click the providers navigation link:
  • To enroll as a Medicaid provider, click Enroll Today in the web page banner.
  • To certify as a Women's Health Program provider, click the Texas WHP tab under the banner.

Claim Tip of the Week
Question: Does other health insurance have to be filed primary for Texas Health Steps and CHIP preventive care?

Answer: No, other health insurance is not required to be filed with the primary carrier.  Texas Health Steps and CHIP preventive care can be filed directly with the BCBSTX Medicaid (STAR) and CHIP program for reimbursement.


Value Added Services Effective Sept. 1, 2012

BCBSTX Value Added Services are directed at improving the health of pregnant women through increasing access to preventive care. It is important for providers to become aware of services and how they can request or refer clients for these services. Clients can be directed to contact Customer Service at 888-292-4480.

Value Added Services effective Sept. 1, 2012:
  • Infant safety car seats
  • Free pregnancy classes
  • Home wellness visits (for mom and baby post-delivery)
  • Free breast pump and breast feeding coaching
  • Austin Farmers’ Market vouchers (fresh fruit and vegetables)
  • Dental services for pregnant adult members
  • Non-emergency medical transportation (NEMT)
  • Lodging and food coverage (for out of area NEMT travel)
  • Sports and camp physicals
  • Enhanced eye wear frames
  • 24-hour nurse line
For more information on any of these Value Added Services, please review our Medicaid (STAR) and CHIP Value Added Services Training located at http://bcbstx.com/provider/network/medicaid.html, under Medicaid (STAR) and CHIP Provider Training.


Link to BCBSTX Medicaid Website

On this website, you will find links to the Provider Manual, Quick Reference Guide, Services Requiring Prior Authorization, webinars/trainings 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

For Member Outreach inquiries, BCBSTX Medicaid (STAR) and CHIP members may contact
Sonia Saenz, Senior Outreach Specialist/Member Advocate, sonia.saenz@wellpoint.com, 512-349-4883

Senior Outreach Specialist/Member Advocate
Sonia Saenz, sonia.saenz@wellpoint.com, 512-349-4883
If unable to reach Sonia, please contact Lupe Yanez at guadalupe.yanez@wellpoint.com, 512-349-4887

 


BCBSTX makes no endorsements, representations, or warranties about any products or services offered by
independent, third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or
services offered by them. If you have any questions about the products or services mentioned in this newsletter,
contact the vendor directly.

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an Independent Licensee of the Blue Cross and Blue Shield Association.

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Blue Review Medicaid (STAR) & CHIP Update • November 9, 2012 • www.bcbstx.com