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Blue Review - Blue Cross and Blue Shield of Texas

February 15, 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.

OB/GYN Claims and Billing Seminar and Webinar
Join BCBSTX Medicaid (STAR) and CHIP provider network representatives for a training focusing on OB/GYN claims and billing. We invite billing and clinical staff to attend; we will provide valuable information pertaining to all areas of the OB/GYN practice. Some of the topics that will be covered include:
  • The new CHIP Perinate Postpartum billing requirements
  • Notice of Pregnancy form
  • Benefit change to Medicaid (STAR) Postpartum visits and billing requirements
  • Provider responsibility for pregnant CHIP members
  • Obstetric clinical education tools available on the BCBSTX website
  • Information on how your patients can attend free prenatal class
  • And more....
This event will take place Feb. 19, 2013, Noon – 2 p.m.

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: Feb. 19
    : Noon – 2 p.m.

    RSVP: Please RSVP by calling 512-349-4896 or email juanita_hill@bcbstx.com. The deadline to RSVP is noon, Feb. 18, 2013.
  • Webinar

    Date: Feb. 19
    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.

Referrals to Providers and Laboratories
Only Medicaid attested providers and laboratories are eligible for reimbursement under the Medicaid Program. Providers must ensure referrals are to Medicaid attested providers and Medicaid attested laboratories.

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 www.tmhp.com.

Submitting Secondary Claims

All secondary claims must be submitted on paper with a copy of the primary EOB attached. Please mail claims to the following address: 
Blue Cross and Blue Shield of Texas
P. O. Box 684787
Austin, TX 78768-4787

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
Blanco, Burnet, Lampasas, Llano, Williamson (Georgetown)

Shelby Robinson, shelby_robinson@bcbstx.com, 512-349-4897
Austin County, Bell, Burleson, Lee, Milam, San Saba, Washington, Williamson (Round Rock)

Britton Thibodeaux, britton_thibodeaux@bcbstx.com, 512-349-4898
Bastrop, Caldwell, Colorado, Comal, Fayette, Gonzales, Guadalupe, Hays, Lavaca

Dee Culver, deanna_culver@bcbstx.com, 512-349-4899
Travis, Williamson (except Georgetown, Round Rock)

Clinical Outreach & Education, Quality/Compliance
Kathy Clark, kathy.clark@wellpoint.com, 512-349-4880

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.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.

1001 E. Lookout Drive, Richardson, TX 75082

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Blue Review Medicaid (STAR) & CHIP Update • February 15, 2013 • www.bcbstx.com