Blue Cross and Blue Shield of Texas (BCBSTX)
Richardson, TX 75082
800-451-0287
TDD: 800-735-2989 (for hearing impaired)
BCBSTX provider portal
Electronic Commerce Services
For information about Electronic Data Interchange (EDI) transactions, such as electronic claim submission
Need Assistance/Have Questions?
Email [email protected]
BCBSTX Provider Customer Service Numbers
BlueCard®
BlueCard is our out-of-area program that allows members from other Blue Cross and Blue Shield Plans to receive health care benefits when travelling or residing in another Blue Plan's service area.
Eligibility and benefits
(out-of-state subscribers)
800-676-BLUE (2583)
Claim status inquiries (out-of-state subscribers) contact Availity® or other electronic connectivity vendor.
Claim adjustments call 800-451-0287*
*interactive voice response (IVR) system — to access, you must have document control number (claim number)
Blue Choice PPOSM and indemnity plans
Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 800-451-0287*
Claim status inquiries contact Availity or other electronic connectivity.
Claim adjustments call 800-451-0287*
*interactive voice response (IVR) system – to access, you must have document control number (claim number)
Blue Cross Medicare Advantage
Customer Service 877-774-8592
Care Management Programs
855-462-1781
Federal Employee Program (FEP) — PPO
Eligibility and benefits contact Availity or other electronic connectivity vendor or call 800-442-4607*
Claim status inquiries contact Availity or other electronic connectivity.
Claim adjustments call 800-451-0287*
*interactive voice response (IVR) system — to access, you must have document control number (claim number)
Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 800-528-7264
Behavioral health services – claims status inquiries contact Availity or other electronic connectivity vendor or call 800-442-4607*
Behavioral health services – claim adjustments call 800-442-4607
Blue Essentials
Eligibility and benefits contact Availity or other electronic connectivity vendor or call 877-299-2377*
Claim status inquiries contact Availity or other electronic connectivity vendor
Claim adjustments call 877-299-2377*
*interactive voice response (IVR) system – to access, you must have document control number (claim number)
Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members
Fax: 866-589-8254
Blue Cross Blue Shield of Texas
Medical Care Management
P. O. Box 660027
Dallas, TX 75266-0027
Prior authorization of Medical Services for the Health Insurance Marketplace for Blue Advantage HMO Members
855-462-1785
Fax: 866-589-8253
University of Texas (UT Select)
Eligibility and benefits contact Availity or other electronic connectivity vendor or call 800-451-0287*
Claim status inquiries contact Availity or other electronic connectivity vendor
Claim adjustments call 877-299-2377*
*interactive voice response (IVR) system – to access, you must have document control number (claim number)
Other Customer Service Numbers
Behavioral health services mental health and chemical dependency
For prior authorization and referrals managed by BCBSTX: (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services)
Call 800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card.
Submit completed forms to:
BCBSTX Behavioral Health Unit
PO Box 660241
Dallas, TX 75266-0241
Fax 877-361-7646
Claims submission address:
Blue Cross and Blue Shield of Texas
P O Box 660044
Dallas, TX 75266-0044
For prior authorization and referrals managed by Magellan:
Magellan Behavioral Health Providers of Texas, Inc.
800-729-2422
Behavioral health services- claims status inquiries
For services managed by BCBSTX:
Contact Availity or other electronic connectivity vendor or call 800-451-0287*
*interactive voice response (IVR) system — to access, you must have full member's information (for example, member's ID, patient’s date of birth, etc.)
For services managed by Magellan:
Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 800-729-2422
Prime Therapeutics
For PPO questions: 800-521-2227
For HMO questions: 877-299-2377*
*interactive voice response (IVR) system- to access, you must have full member's information (for example, member's ID, patient's date of birth, etc.)
AIM Specialty Health®'
AIM Specialty Health
eviCore healthcare
Claim filing address for Commercial products
If a provider must file a paper claim, mail claim to
Blue Cross and Blue Shield of Texas
P.O. Box 660044
Dallas, TX 75266-0044
Claim review submission address
P.O. Box 660044
Dallas, TX 75266-0044
Request for claim review form and instructions
Availity®
--- Authorizations & Referrals submissions (replacing iExchange system)
— electronic claims filing system
Submit prior authorization and referrals for BCBSTX managed services via
Availity client services 800-AVAILITY (282-4548)
Availity website
EDI Guide
Benefit disclosure information (form available online)
Blue Cross and Blue Shield of Texas
Pre-Service Allowed Benefit Disclosure Request
P.O. Box 650489
Dallas, TX 75265-0489
Fax: 972-766-0371
Please do not send patient-specific predetermination information to this address or fax number.
Predetermination requests (form available online)
Mail:
Blue Cross and Blue Shield of Texas
Attn: Predetermination Dept.
P.O. Box 660044
Dallas, TX 75266-0044
For status call:
800-451-0287* (Blue Choice PPO)
877-299-2377* (Blue Essentials and Blue Advantage HMO)
877-774-8592 (Blue Cross Medicare Advantage PPO & HMO)
*interactive voice response (IVR) system- to access, you must have full member's information (for example, member's ID, patient's date of birth, etc.)
For urgent requests only:
Fax to: 888-579-7935
Predetermination form andInstructions for submitting requests for predetermination
Note: Predetermination requests for members with Blue Cross and Blue Shield benefits in another state should be sent to the Plan indicated on the member’s ID card.
Utilization management/Medical Management/Case Management
800-441-9188
Fax: 800-252-8815 or 800-462-3272
Case management
800-462-3275
Fax: 800-778-2279
Messages may be left in a confidential voice mailbox after business hours.
Wellness and clinical practice guidelines
Network Management Office Locations
TO AVOID DELAY, DO NOT SUBMIT FORM TO MULTIPLE AREAS/OFFICES.
Please provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management.
Abilene, Midland San Angelo
Blue Cross and Blue Shield of Texas
1001 E Lookout Drive
Richardson, TX 75082-4144
361-878-1623
Fax: 361-852-0624
Email to submit provider inquiries and questions
Austin
Blue Cross and Blue Shield of Texas
Arboretum Plaza II
9442 Capital of Texas Hwy N, Suite 500
Austin, TX 78759-7228
800-336-5696
512-349-4847
Fax: 512-349-4853
Email to submit provider inquiries and questions
Amarillo
Blue Cross and Blue Shield of Texas
1001 E Lookout Drive
Richardson, TX 75082-4144
361-878-1623
Fax: 361-852-0624
Email to submit provider inquiries and questions
Corpus Christi and The Valley
Blue Cross and Blue Shield of Texas
4444 Corona, Suite 148
Corpus Christi, TX 78411-4375
361-878-1623
Fax: 361-852-0624
Email to submit provider inquiries and questions
Dallas
See “North Texas”
El Paso
Blue Cross and Blue Shield of Texas
114 Mesa Park Dr. Suite #300
El Paso, TX 79912 -6156
915-496-6600, press 2
Fax: 915-496-6614
Email to submit provider inquiries and questions
Fort Worth
See “North Texas”
Golden Triangle (Beaumont, Orange, Port Arthur)
Blue Cross and Blue Shield of Texas
2615 Calder St, Suite 700
Beaumont, TX 77702-1954
800-637-0171, press 3 or 713-663-1149
Fax: 713-663-1227
Email to submit provider inquiries and questions
Houston
Blue Cross and Blue Shield of Texas
1800West Loop South, Suite 600
Houston, TX 77027-3279
800-637-0171, press 3
713-663-1149
Fax: 713-663-1227
Email to submit provider inquiries and questions
Laredo
See “San Antonio and Laredo”
Lubbock
Blue Cross and Blue Shield of Texas
1001 E Lookout Drive
Richardson, TX 75082-4144
361-878-1623
Fax: 361-852-0624
Email to submit provider inquiries and questions
McLennan and Wichita Counties
Blue Cross and Blue Shield of Texas
4444 Corona, Suite 148
Corpus Christi, TX 78411-4375
361-878-1623
Fax: 361-852-0624
Email to submit provider inquiries and questions
North Texas Dallas, Fort Worth, East Texas (Excludes McLennan and Wichita counties)
Blue Cross and Blue Shield of Texas
1001 E. Lookout Drive
Richardson, TX 75082-4144
800-749-0966
972-766-8900
Fax: 972-766-2231
Email to submit provider inquiries and questions
San Angelo
See “Abilene, Midland and San Angelo”
San Antonio and Laredo
Blue Cross and Blue Shield of Texas
17806 IH 10 West, Bldg II, Suite 200
San Antonio, TX 78257-8222
361-878-1623
Fax: 361-852-0624
Email to submit provider inquiries and questions
The Valley
See “Corpus Christi and The Valley”
Wichita County
See “McLennan and Wichita Counties”
Ancillary Network Management
Independent Clinical / Specialty Labs
Phone: 713-354-8140
Fax: 713-663-1227
Email to submit provider inquires
Ambulance
IP Only Rehab Facilities
Imaging
LTAC (Long-Term Acute Care Hospital)
Radiation Therapy Center
Phone: 972-766-4628
Fax: 972-766-2231
Email to submit provider inquires
Home Health
Skilled Nursing Facilities
Post-Acute Brain Injury Facilities
Phone: 210-558-5101
Fax: 210-558-5176
Email to submit provider inquires
Diabetic Management
Disease Management
Durable Medical Equipment (DME)
Hearing Aid Supplier
Prosthetics/Orthotics
Sleep Studies Centers
Phone: 972-766-1613
Fax: 210-340-1401
Email to submit provider inquires
Home Infusion Therapy
Home Health Dialysis
Hospice
Renal Dialysis
Phone: 972-766-5125
Fax: 210-340-1401
Email to submit provider inquires
Behavioral Health Facilities
Psychiatric Facilities
Residential Treatment Centers for Mental Health and
Substance Abuse Facilities
Note: For behavioral health professional providers, refer to the Network Management Office Locations listed above.
Phone: 972-766-1380
Fax: 713-663-1227
Email to submit provider inquires
Ambulatory Surgery Centers (ASC) – Independent, Non-Hospital owned
Catherization Center
Independent (Non-Hospital owned) Surgery Centers
Phone: 713-354-7033
Fax: 713-663-1227
Email to submit provider inquires
Birthing Centers
Freestanding Emergency Rooms
Phone: 972-766-1110
Fax: 713-663-1227
Email to submit provider inquires
Blue Cross Medicare Advantage
Network Management
1001 E. Lookout Drive
Richardson, TX 75082
Phone: 972-766-7100
[email protected]