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Currently, specialists and other providers must obtain a referral from a BCBSTX members PCP or referring provider prior to treating that member.
Electronic Claim Submission-Maximizes Claim Processing Any claim that can be submitted on paper can be submitted electronically. If you need more information on how to submit claims electronically call 1-800-AVAILITY (282-4548) or log on to Availity.
About Blue Cross and Blue Shield of Texas BCBSTX is a Division of Health Care Service Corporation (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the countrys largest customer-owned health insurer and fourth largest health insurer overall.
About Blue Cross and Blue Shield of Texas BCBSTX is a Division of Health Care Service Corporation (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the countrys largest customer-owned health insurer and fourth largest health insurer overall.
If the provider or member does not get prior authorization for out-of-network services, the claim may be denied or will be subject to a post-service medical necessity review. Emergency services are an exception. Reminder: Submit your prior authorization requests with the appropriate documentation and level of urgency.

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Currently, specialists and other providers must obtain a referral from a BCBSTX members PCP or referring provider prior to treating that member.
Contact Us I have questions about enrolling in a new plan: 1-800-531-4456. Im a member with a question for customer service: 1-888-697-0683. I want to make a payment:
Referrals are required under the HealthSelect of Texas plan. A referral is a written order from your primary care provider (PCP) for you to see a specialist. For most services, you need to get a referral before you can get medical care from anyone except your PCP.

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