| Applies To* |
All MCO Credentialed Faculty**
**For further clarification of "All MCO Credentialed Faculty" refer to Table of Contents.
|
| PCP Services |
N/A |
| Laboratory Services |
Includes services performed at :
- Aston Lab
- LabCorp
- Quest Diagnostic
|
| Radiology Services |
Includes services performed at:
- Algur H. Meadows Diagnostic Imaging Center
- Aston Radiology
- Mary Nell & Ralph B. Rogers MRI Center
|
| Participating Facilities |
- Children’s Medical Center
- St. Paul Medical Center
- Parkland Health & Hospital System
- Zale Lipshy University Hospital
- UT Southwestern Clinical Procedure Center (ASC)
- Moncrief Radiation Oncology Center (MROC)
|
| Referral Requirements |
N/A |
| Authorization Requirements |
For Precertification call (800) 441-9188 or the Blue Link System (800) 413-0869. For problems concerning the Blue Link system, please call their help line at 972-766-8474.
The following require precertification and concurrent review:
- All inpatient hospital admissions
- Selected outpatient procedures and diagnostic tests
- Extended care, including Hospice and Home Health Care services and Skilled Nursing Facility admissions
- Home Infusion Therapy **
- Continuous Passive Motion (CPM) device rental
**These services require authorization from Blue Cross, 800-441-9188 and can be provided by UT Southwestern Zale Lipshy Home Health. This Home Health group has a contract with Blue Cross and should be utilized whenever possible. For referrals and questions regarding Zale Lipshy Home Health Services, please contact 214-590-9600.
Mental Health or Chemical Dependency Precertification call (800) 528-7264.
|
| Managed Care Plan |
ParPlan and ParSelect (Lone Star Gas employees only)-(Traditional Indemnity Plans) |
| Identification Card |
"Blue Cross/Blue Shield of Texas" or "ParSelect" in blue at the upper right hand corner |
| FSC* |
21 (Registration Level)
346 Invoice Level Facility Billing |
| Contract Date(s) |
January 1, 1992 – ParPlan and ParSelect |
| Eligibility* |
Varies by Plan - See ID Card |
| Claims Mailing Address |
Claims placed in FSC 21 are automatically routed to the appropriate office based on the subscriber’s ID number. Or send to:
BCBSTX:
P.O. Box 660044
Dallas, TX 75266-0044
Customer Service:
(800) 441-9188 |
| Deductible/Co-Payment |
Varies by Plan - See ID Card and confirm with eligibility. |
| Claims Submission |
|
| Claims Payment |
- Claims shall be paid within 45 days from receipt of a complete claim.
|
| Provider Relations |
Belinda Nyahanana (972) 766-0972
www.bcbstx.com |
| Comments |
-
-
Blue Link ID numbers can be obtained from Blue Cross
Blue Shield online provider directory at:
Blue Link ID Numbers
|
