For questions about your vision coverage, please call BCBSTX customer service at 1-888-657-6061 (TTY 711). For counties outside the Travis and Central Medicaid Rural Service Area, please contact the Medicaid Network Department at 1-855-212-1615 or via email atTexasMedicaidNetworkDepartment@bcbstx.com. View your child's behavioral health coverage. ALL rights reserved. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. Enter your batch ID number in the Batch ID field below, and click Search . This product includes CPT which is commercial technical data and/or computer databases and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Contact your provider advocate or call Provider Services at 877-842-3210 for more information. Use our Provider Finder to search for doctors and pharmacies near you. End of Continuous Medicaid Coverage Ambassador Toolkit. Please share the HHSC Flyer with your patients to help them keep their benefits. If you want to see an out-of-network provider, you need to get a prior authorization for to ensure Magellan has the provider information needed to accurately pay claims. BCBSTX serves STAR Kids members in both the Travis and Central Service Areas. Magellan also offers emergency and crisis support. This will initiate a one-time retention payment for non-HCBS waiver providers. We are open 8:00 a.m. to 8:00 p.m. Central Time, Monday through Friday. For Service Coordination, call 1-877-301-4394 (TTY 711), 8:00 a.m. to 5:00 p.m. Central Time, Monday through Friday. Mental Health/Substance Abuse services do not need an OK from your PCP when you are not in the hospital, but you do have to see a Magellan provider. Social Security Number. Learn about upcoming Member Advisory Group meetings, behavioral health or substance abuse treatment services. The STAR program is for people who qualify for Medicaid and who are either pregnant, have limited income, are newborns or receive cash assistance (Temporary Assistance for Needy Families or TANF). U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer databases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. The STAR Kids program provides Medicaid services for children and youth age 20 and younger with disabilities. the code is a benefit of Texas Medicaid. Most PDF readers are a free download. Visit the Office of Consumer Credit Commissions (OCCC) website to get tools and skills to help you make informed financial decisions. Providers who have completed other CMS/State-approved Cultural Competency Training may attesthere. For additional assistance, call 1-888-887-9003, Monday - Friday from 8 a.m. to 8 p.m. Information and Interpreters are available in many languages. view copays for different services, based on income guidelines. Welcome to the Online Fee Lookup for Texas Medicaid, the Health and Human Services Commission (HHSC) Family Planning Program, and the Children with Special Health Care Needs (CSHCN) Services Program. PDF File is in portable document format (PDF). You can also call Magellan directly. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. BCBSTX allows members with special health care needs to have direct access to the right specialists for their conditions and identified needs. First Name is an optional field. Its Time for TX Medicaid Members to Renew! To request aSTAR, CHIP, or STAR KidsNetwork Participation Agreement, please refer toRequest Contract/Agreement/Network Participationon theNetwork Participation page. Your vision coverage includes an eye exam every 12 months and glasses or contact lenses, when medically necessary. To learn more, visit the OIG website. You should have received a Batch ID if you performed a search for: 11 to 50 procedure codes. A range of procedure codes. You have the right to ask for an appeal. If your child sees and out-of-network PCP or a PCP from a non-Medicaid plan, we can help you stay with that PCP. BCBSTX has been around for over 90 years and is the largest provider of health benefits in the state of Texas. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government Use. The site may also contain non-Medicare related information. Last updated on 12/15/2021 Texas Medicaid has a wide variety of programs that help low-income women, families, seniors, and kids stay healthy, including: Children's Medicaid (including Texas Health Steps) Medicaid for the Elderly and People with Disabilities Medicaid Buy-In for Children Medicaid Buy-In for Adults Medicaid for Parents and Caretakers Nows the time to encourage our members to catch up on their health. Your child's prescription benefits are administered by BCBSTX. The AMA is a third party beneficiary to this Agreement. BCBSTX allows you to see out-of-network Medicaid specialists for medically necessary services. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. Its Time for TX Medicaid Members to Renew! Children's Medicaid is a health care program for children in low-income families. Please note:that additional credentialing is not required for those providers already credentialed in the STAR, CHIP, or STAR Kids networks and whose credentialing is current. Should the for egoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "accept". You can also speak with someone about how to get information in other languages or formats at no extra charge. BCBSTX works with Magellan Health Services (Magellan) for mental health and substance abuse services. For questions about your child's behavioral health coverage, please call Magellan directly at 1-800-327-7390 (TTY 1-800-735-2988). All members receiving long-term services and supports, or those who request them will receive service coordination services from BCBSTX STAR Kids. Provider Search HEALTH PLAN * Select One CSHCN Services Program STAR STAR Health STAR+PLUS Traditional Medicaid Pharmacy Provider Search Children's Medicaid Dental Services MMP STAR Kids Kidney Health Care Family Support Services Children's Health Insurance Program Healthy Texas Women (HTW) The sole responsibility for the software, including any CDT and other content contained therein, is with TMHP or the CMS; and no endorsement by the ADA is intended or implied. To get auxiliary aids and services, or to get written or oral interpretation to understand the information given to you, including materials in alternative formats such as large print, braille or other languages, please call BCBSTX STAR Customer Service at 1-888-657-6061 (TTY 711). BY CLICKING BELOW ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "ACCEPT". You can also learn more about filing an appeal. For the Behavioral Health Services Hotline, call Magellan Health Services at 1-800-424-0324 (TTY 1-800-635-2883). We have served CHIP members in the Travis Service Area since 2012. Home Services and Providers A-Z Services and Providers A-Z Download a PDF listing our services and providers. After you choose a PCP, you will then get a new ID card that shows Commercial PCP or Dual Eligible for members that have Medicare. To choose a doctor or Primary Care Provider (PCP), call Superior Member Services. You may call at any time of day or night, and on any day of the week. Providers may refer to the Contracted Rate search to determine whether Your childs vision benefits are administered by Davis Vision. Your childs vision benefits are administered by Davis Vision. Texas Medicaid members must renew when notified by the Texas Health and Human Service Commission (HHSC). Instead, you must exit from this computer screen. This product includes CDT, which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Dental Association, 211 East Chicago Avenue, Chicago Illinois, 60611. Learn about upcoming Community Advisory Committee meetings. If an unexpected medical situation arises, a nurse can help you decide if you should call your doctor, visit the ER or urgent care, or treat the problem yourself. Call customer service at1-877-688-1811(TTY 711) to replace your ID card if it is lost. HIPP helps people who might otherwise be uninsured. Medicaid and the Children's Health Insurance Program (CHIP) provide health coverage for low-income children, families, seniors and people with disabilities. If you would like to come and share your ideas with BCBSTX staff and community partners on what you like about your plan benefits or where we can do better, please call the member advocate toll-free for details at 1-877-375-9097 (TTY 711). The OCCC has resources to help understand your financial choices and obligations. You do not need a referral to get emergency services. View more information on asking for a fair hearing. To ask for an appeal or a fair hearing, call the Member Advocate in the Travis service area at 1-877-375-9097 (TTY 711). If you have any questions regarding the Cultural Competency Provider Training please contact your provider network representative. For questions about your child's vision coverage, please call BCBSTX customer service at 1-877-688-1811 (TTY 711). WARNING: THIS IS A TEXAS HEALTH AND HUMAN SERVICES INFORMATION RESOURCES SYSTEM THAT CONTAINS STATE AND/OR U.S. GOVERNMENT INFORMATION. If you have a speech or hearing disability, call 711 or 1-800-735-2989 (toll-free). All Rights Reserved. Your member's card shows if you have one. You can speak with someone in English or Spanish. Please call Service Coordination so we can get information on PCP that you want to use, and we will help get the appropriate PCP assigned. You can view copays for different services, based on income guidelines. You can call Monday to Friday, 8:00 a.m. to 6:00 p.m. Central Time. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. enrollment application performing , rate keys for some hcs txhml , medicaid surety bonds for ambulance , Children's Health Insurance Program (CHIP), Children with Special Health Care Needs Services Program, Enrollment Application for Performing Providers v. I, Provider Rate Updates for HCS and TxHmL Providers, Provider Enrollment Electronic Signature Instructions.pdf. End of Continuous Medicaid Coverage Ambassador Toolkit. All rights reserved. You do not need referrals to see in-network specialists. AMA/ADA End User License Agreement You do not need an OK from your PCP to get family planning help. Your provider can contact us with questions about eligibility, benefits, provider network referrals or claim statuses. Some CHIP members have copays. Expenditures include direct payments to physicians, hospitals BCBSTX also allows you to see out-of-network OB/GYN providers for medically necessary services. For questions about drug coverage, please contact us at 1-888-657-6061 (TTY 711). For the Member Advocate in the Central MRSA service area, call 1-855-497-0857 (TTY 711). They can also contact us about appeals and complaints. A PCP is your main health care provider and will arrange your care with other doctors and hospitals. You may call at any time of day or night, and on any day of the week. You should call your childs PCP after the emergency so follow-up care can be planned. Call between 8:30 a.m. and 5:00 p.m. Central Time, Monday to Friday. Location: Type of Care: Search. This help line is staffed 24 hours a day, 7 days a week with registered nurses who can help you get answers to your health questions. Welcome Texas Medicaid Providers The Texas Medicaid & Healthcare Partnership provides the resources to help providers succeed with their Medicaid practice My Account What brings you in today? Please share the HHSC Flyer with your patients to help them keep their benefits. If you have questions, call Magellan Health Services at 1-800-327-7390 (TTY 1-800-735-2988). To view this file, you may need to install a PDF reader program. If you need to contact Texas Health Steps, call them toll-free at 1-877-847-8377 (1-877-THSTEPS). Each quarter, BCBSTX holds a Community Advisory Committee (CAC) Meeting so that we can find out how we can serve you better. Medicaid Providers By ensuring access to employer-sponsored health insurance, people who are eligible for HIPP can receive services that are not normally covered through Medicaid. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago IL 60611. Remember, your primary care physician makes referrals to other health care providers for you. A Magellan Health Care Coordinator will work with your childs service coordinator to ensure your child has access to the behavioral health services needed. CPT only copyright 2022 American Medical Association. Please choose a PCP from the provider network when you join. To support quality care, we are providing information to providers and members to encourage discussions on health topics. IF YOU DO NO AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN. Call customer service at 1-888-657-6061 (TTY 711) to replace your ID card if it is lost. For questions about your child's behavioral health coverage, please call Magellan directly at 1-800-424-0324 (TTY 1-800-635-2883). 2. If your provider needs to contact us, they may call the Provider Services Hotline at 1-877-560-8055from 8:00 a.m. to 8:00 p.m. Central Time, Monday through Friday. Please call them directly to learn more about your childs dental coverage: Call Dentaquest at 1-800-516-0165 and MCNA Dental at 1-800-494-6262. ANY UNAUTHORIZED USE OR ACCESS, OR ANY UNAUTHORIZED ATTEMPTS TO USE OR ACCESS, THIS SYSTEM MAY SUBJECT YOU TO DISCIPLINARY ACTION, SANCTIONS, CIVIL PENALTIES, OR CRIMINAL PROSECUTION TO THE EXTENT PERMITTED UNDER APPLICABLE LAW. A Magellan Health Care Coordinator will work with your child's service coordinator to ensure your child has access to the behavioral health services needed. Medicaid and CHIP. You can also speak with someone about how to get information in other languages or formats at no extra charge. To view this file, you may need to install a PDF reader program. If your child is having a mental health emergency, call Magellan. Copyright 2022Health Care Service Corporation. You can choose a different PCP for each member. Please call them directly to learn more about your child's dental coverage: If you do not know your child's CHIP dental plan, call the CHIP enrollment broker at 1-800-964-2777. Texas Medicaid and CHIP provider resources include information on provider enrollment and re-enrollment, rate analysis, the CHIP Perinatal program, physician-administered drugs and communications resources. Find one who meets your needs using the search tool below. CPT is a registered trademark of American Medical Association. To get auxiliary aids and services, or to get written or oral interpretation to understand the information given to you, including materials in alternative formats such as large print, braille or other languages, please call BCBSTX STAR Kids Customer Service at 1-877-688-1811 (TTY 711). For questions about your child's vision coverage, please call BCBSTX customer service at Service coordination assists you and your child in coordinating acute and long-term care services. Learn how to file an appeal with BCBSTX. Use ourProvider Finderto doctors and pharmacies near you. . External link You are leaving this website/app (site). You should have received a Batch ID if you performed a search for: Click the icon for the requested Batch ID to download the results. Care Find a Doctor Get the care you need from a provider you choose We've partnered with many providers in your area. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. Your child's prescription benefits are administered by BCBSTX. 3. You may leave a voice mail outside of our normal business hours or on weekends and holidays. The scope of this license is determined by the ADA, the copyright holder. Expenditure information is obtained from the Texas Medicaid & Healthcare Partnership through the databases in the Vision 21 platform, which includes paid claims, managerial reporting of cash flow, provider and client information, and managed care encounter data. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). Provider Search Summary. Search for different types of providers, like: Primary care providers Specialists Hospitals and facilities Labs (to get blood tests) Behavioral health providers Pharmacies You, your employees and agents are authorized to use CPT only as contained in materials on the Texas Medicaid & Healthcare Partnership (TMHP) website solely for your own personal use in directly participating in healthcare programs administered by THHS. The CHIP and CHIP Perinatal program is available to children (age 18 and younger) and pregnant women who do not qualify for Medicaid. You can speak with someone in English or Spanish. If you do not agree to the terms and conditions, you may not access or use the software. The ADA is a third party beneficiary to this Agreement. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. BCBSTX is pleased to provide a CHIP plan. If you have questions, please call customer service toll-free at1-877-688-1811 (TTY 711). Find more information about your child's assigned service coordinator by logging in to Blue Access for MembersSM (BAM). View the HIPAA Notice of Privacy Practices. If you do not know your child's dental plan, call the enrollment broker at 1-800-964-2777. For the 24/7 Nurse Hotline, call 1-844-971-8906 (TTY 711). View Participating Counties You may also request interpreter services. The provider does not need to be part of BCBSTX. To get auxiliary aids and services, or to get written or oral interpretation to understand the information given to you, including materials in alternative formats such as large print, braille or other languages, please call BCBSTX CHIP Customer Service at 1-888-657-6061 (TTY/TDD 711). Top of Page. To ask for an appeal or a fair hearing, call the Member Advocate in the Travis service area at 1-877-375-9097 (TTY 711) from 8:30 a.m. to 5:00 p.m. Central Time, Monday to Friday. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. Any data elements that are populated will be used to determine the client's eligibility. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. You can speak with someone in English or Spanish. BCBSTX is asking for your help to boost awareness. CHIP is a health care program for children without health insurance whose families earn too much to get Medicaid but cannot afford health insurance. PDF File is in portable document format (PDF). The site may also contain non-Medicare related information. BY ACCESSING AND USING THIS SYSTEM YOU ARE CONSENTING TO THE MONITORING OF YOUR USE OF THE SYSTEM, AND TO SECURITY ASSESSMENT AND AUDITING ACTIVITIES THAT MAY BE USED FOR LAW ENFORCEMENT OR OTHER LEGALLY PERMISSIBLE PURPOSES. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. CDT is a trademark of the ADA. This new site may be offered by a vendor or an independent third party. Applications are available at the American Dental Association web site, http://www.ADA.org. Magellan also offers emergency and crisis support. They can also contact us about appeals and complaints. For the 24/7 Nurse Hotline, call 1-855-802-4614 (TTY 711). Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. CDT is provided as is without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Texas Health and Human Services Commission, Texas Medicaid and Healthcare Partnership, Texas Department of Family and Protective Services. Find A Provider. Magellan also offers emergency and crisis support. U.S. GOVERNMENT RIGHTS. Data available as of: June 20, 2023. For the Travis Service Area call toll-free at 1-877-375-9097, or in MRSA Central call 1-855-497-0857 (TTY 711). Provider Enrollment TMHP Contact Center: Provider Enrollment Last updated on 10/7/2022 The goal of Texas Medicaid is to provide health care to over 4.2 million Texas residents who might otherwise go without medical care for themselves and their children. This includes a standing referral to a specialty doctor, or having a specialist as a PCP if needed. These materials contain Current Dental Terminology, Fourth Edition (CDT), Copyright 2022 American Dental Association (ADA). One option is Adobe Reader which has a built-in reader. If your provider needs to contact us, they may call the Provider Services Hotline at 1-877-784-6802 from 8:00 a.m. to 8:00 p.m. Central Time, Monday through Friday. They can also help you get a provider's: Professional qualifications Specialty Medical school information Residency information Board certification Demographics Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. We have served STAR members in the Travis Service Area since 2012. If you do not know your child's CHIP dental plan, call the STAR Kids enrollment broker at 1-877-782-6440 (toll-free) 8 a.m. to 6 p.m. Central Time, Monday to Friday. Cultural Competencyis the ability of individuals and systems to provide services effectively to people of various cultures, races, ethnic backgrounds and religions in a manner that recognized values, affirms and respects the worth of the individual and protects and preserves dignity. Client Eligibility Lookup. Codes that are not listed in the fee schedules may be reimbursed using a contracted rate. If you do not agree with a decision BCBSTX has made about your request for benefits or services, you have the right to ask for a Medicaid fair hearing from the Health and Human Services Commission (HHSC). You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Texas Medicaid members must renew when notified by the Texas Health and Human Service Commission (HHSC). All Rights Reserved. Children on Medicaid receive dental benefits that are administered by either Dentaquest or MCNA Dental. You can also call Magellan at 1-800-424-0324. Date of Birth. CMS DISCLAIMER. Nurse Practitioner (NP) or Physician Assistant (PA), Clinic such as Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs). Children's Health Insurance Program (CHIP), View the HIPAA Notice of Privacy Practices, Office of Consumer Credit Commissions (OCCC) website, View more information on asking for a fair hearing. If you need help finding a specialty doctor, mental health/substance abuse services or an OB/GYN provider, call Customer Service at 1-888-657-6061 or TTY 711. This new site may be offered by a vendor or an independent third party. You may also request interpreter services. BCBSTX STAR Kids members get behavioral health/substance abuse services through Magellan Health Services. Knowing your choices makes it easier to manage your personal finances so you can meet your financial goals. End Users do not act for or on behalf of the CMS. You are leaving this website/app (site). THE LICENSE GRANTED HEREIN IS EXPRESSLY CONTINUED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. Member Handbook. You may call at any time of day or night, and on any day of the week. 211 Texas; Apply for Benefits; Compact with Texans; Department of State Health Services . Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Medicaid Provider Information on COVID-19 Coverage, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms, Request Contract/Agreement/Network Participation, TexasMedicaidNetworkDepartment@bcbstx.com, Reminder: Survey to Assess Medicaid Provider Experiences, Alert: Medicaid Members Can't be Balance Billed, Catch Up on Routine Vaccines and Well-Child Visits Texas Medicaid, Reminder Texas Medicaid Providers Help Our Members Get Ready for Redetermination, Additional Changes to Prior Authorization Codes for Medicaid Members, Effective July 1, 2023. Topics: Medicaid Business Resources Pages Registered Dietitian's Role in a Nursing Facility Applications are available at the American Medical Association website, www.ama-assn.org/go/cpt. Learn about upcoming Community Advisory Committee meetings. The best way to protect your Medicaid or CHIP benefits is to make sure Texas Health and Human Services Commission (HHSC) has your most up-to-date contact information. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. External link You are leaving this website/app (site). BCBSTX is pleased to offer health plans for individuals who qualify for Medicaid (STAR, STAR Kids) and CHIP programs. Search for doctors, hospitals, pharmacies, urgent care and more using Provider Finder. Search results for residential providers, sometimes called facility-based providers, include information about inspections, as well as contact information and if they accept Medicaid or Medicare. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.