Reminder: Phone System Update for Eligibility and Benefits

Several benefit categories have been evaluated in the Blue Cross and Blue Shield of Texas (BCBSTX) Interactive Voice Response (IVR) phone system. This evaluation confirmed that the IVR adequately quotes the same level of information a Customer Advocate would provide. As a result, beginning Dec. 12, 2016, the option for Customer Advocate assistance will be removed from the call flow for common benefit categories.

BCBSTX strongly encourages providers to check patient eligibility and benefit information prior to every scheduled appointment, and having quick access to this data is imperative. The fastest and most efficient way to obtain eligibility and benefits information is electronically through Availity^TM  , or your preferred Web vendor. Taking advantage of electronic options allows retrieval of needed information at your convenience.

If eligibility and benefits are unable to be verified online, the same information is often readily accessible through our IVR phone system. In addition, a confirmation number will be provided for your records, after the phone system has completed the quote.

To learn more about obtaining eligibility and benefits electronically, join us for a complimentary Back to Basics: “Availity 101” Webinar. Visit the Provider Training page in our online Education and Reference Center for additional information, or select a session date and time below to register now:

Back to Basics: Availity^TM 101 Webinars:

• Dec. 1, 2016 – 11 a.m. to noon, CT
• Dec. 8, 2016 – 11 a.m. to noon, CT
• Dec. 15, 2016 – 11 a.m. to noon, CT
• Dec. 22, 2016 – 11 a.m. to noon, CT

For more advanced training on online tools and resources, email our Provider Education Consultant team at PECS@bcbstx.com.

Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have questions, please call the number on the member’s ID card.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.