Blue Cross/Blue Shield Claims Filing Process
New Changes Effective Sept. 1

A system conversion for HMO Blue Texas (formerly NYLCare Health Plans of the Gulf Coast Inc.) is scheduled for completion Sept. 1. Highlights of the changes include:

• One-claims filing process for all the Blue Cross and Blue Shield of Texas affiliated HMOs;
  
  
• 24-hour access to electronic options for claims submission, precertification and referrals for all the Blue Cross and Blue Shield of Texas-affiliated HMOs, which will include HMO Blue Texas physicians and facilities in the GulfCoast area;
  
  
• A BlueLINK Interactive Voice Response System and online access via the Internet available for HMO Blue Texas (Gulf Coast) physicians at (800) 413-0869 and http://providers.bcbstx.com;
  
  
• A BlueLINK Help Desk at 1-800-441-9188, ext. 68474.

In addition, Blue Cross and Blue Shield of Texas offer these tips to help physicians with filing HMO claims and related HMO transactions:

• Include the BCBSTX provider number on all HMO claims.
  
  
• Copy the new plastic HMO Blue Texas member ID card to capture and record new claims filing information and other important details, such as new group numbers and current subscriber members. The paper member ID cards issued prior to the Sept. 1 system conversion date contain information that, if used to file a claim, will cause delays or nonpayment of claims filed after Sept. 1.
  
  
• Use the new HMO claims filing and encounter data submission addresses if you are unable to file electronically:
  
  HMO Blue Texas
  P.O. Box 660044
  Dallas, TX 75266-0044
  
  HealthSelect Plus
  P.O. Box 833804
  Richardson, TX 75083
  
  
• Contact the BlueLINK Help Desk for your BlueLINK ID number or to request a provider directory.

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©2006 Texas Medical Center

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URL: http://www.tmc.edu/tmcnews/08_15_01/page_11.html