|January 11, 2013 |
For Travis Service-Area Medicaid (STAR) & 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.
January 16, 2013 – Provider Orientation: A Comprehensive Overview
Lunch will be provided for Live Seminar attendees; all attendees will have the opportunity to play games and win prizes. You can attend this event in two ways:
- Live Seminar at: BCBSTX Medicaid (STAR) and CHIP Medicaid Office
9442 Capital of Texas Hwy,
Suite 500, Arboretum Plaza II
Austin, TX 78759-6839
Date: Jan. 16, 2013
Time: Noon – 2 p.m.
RSVP: Please RSVP by calling 512-349-4896 or email email@example.com. Deadline to RSVP is noon, Tuesday, Jan. 15, 2013.
Date: Jan. 16, 2013
Time: Noon – 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
Click on the “Join Meeting” button.
Claim Returned for Additional Information
BCBSTX sends a request for additional or corrected information to providers when the claim cannot be processed due to incomplete, missing or incorrect information in the original claims submission.
The request for information includes a form that allows you to return the requested information in an easy-to-follow format. We call this a mailback form. This form must be returned with the requested information in order to process the claim.
BCBSTX may also request additional information retroactively for a claim that has already been paid. The mailback form is also used for these situations.
Time Frame for Returning Requested Information
If you receive a request from BCSTX for additional information, you must provide this information within 21 calendar days from the date of the request or your claim may be denied.
How to Submit Requested Additional Information
To resubmit additional or corrected information on a claim, you should send:
- A copy of the mailback form requesting more information
- Any and all supporting documentation (such as records and reports) that you deem pertinent or that has been requested by BCBSTX
- A copy of the original, corrected CMS-1500 or CMS-14590 claim form
2012-2013 RSV (Respiratory Syncytial Virus) Season
Prior approvals for Synagis were available through BCBSTX beginning Sept. 15, 2012. The PA form can be found at bcbstx.com/provider/network/medicaid.html.
The start of the 2012-2013 respiratory syncytial virus (RSV) season varies based on a patient’s county of residence, with most areas in Texas beginning Oct. 1, 2012, and ends March 15, 2013. To learn more about the Synagis county schedule, visit www.txvendordrug.com.
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:
Provider Customer Service: 888-292-4487, 7 a.m. to 6 p.m. CT, Monday through Friday
For general questions and concerns:
Jamye Rushing, firstname.lastname@example.org, 512-349-4876; Fax: 512-349-4848
Network Provider Representatives
Juanita Hill, email@example.com, 512-349-4896
Burnet, Williamson, Blanco, Lampasas, Llano, San Saba
Shelby Robinson, firstname.lastname@example.org, 512-349-4897
Lee, Austin County, Bell, Burleson, Milam, Washington
Britton Thibodeaux, email@example.com, 512-349-4898
Bastrop, Caldwell, Fayette, Hays, Colorado, Comal, Gonzales, Guadalupe, Lavaca
Dee Culver, firstname.lastname@example.org, 512-349-4899
Clinical Outreach & Education, Quality/Compliance
Kathy Clark, email@example.com, 512-349-4480
For Member Outreach inquiries, BCBSTX Medicaid (STAR) and CHIP members may contact
Sonia Saenz, Senior Outreach Specialist/Member Advocate, firstname.lastname@example.org, 512-349-4883
Senior Outreach Specialist/Member Advocate
Sonia Saenz, email@example.com, 512-349-4883
If unable to reach Sonia, please contact Lupe Yanez at firstname.lastname@example.org, 512-349-4887