Chiropractic & Mixed Therapy Benefits Contained in IVR Phone System as of Jan. 3, 2022
Beginning Jan. 3, 2022, the option to speak to a Customer Advocate will be removed for the chiropractic and mixed therapy (physical, occupational and speech therapies) benefit category within our automated Interactive Voice Response (IVR) phone system. The IVR quotes the same level of patient eligibility and benefits information as a Customer Advocate provides. Remain assured; our Customer Advocates will continue to be available for more complex benefit quotes.
Blue Cross and Blue Shield of Texas (BCBSTX) is committed to providing efficient and secure access to patient information. To better assist providers with understanding the recent IVR change, a list of the benefit categories that are currently contained in the IVR is included below. This listing is continually reviewed and may vary across our different BCBSTX networks, products and/or group policies.
Note: This information/listing is not applicable to Medicare Advantage or Texas Medicaid members. When calling to verify eligibility and benefits for one of these members, refer to the Customer Services phone number on the back of the member’s BCBSTX ID card.
| Air Ambulance | Electrocardiogram (EKG) | Mixed Therapy* | Preventive Care |
| Allergy | Extended Care Facility | MRI | Private Duty Nursing |
| Anesthesia | Ground Ambulance | Office Services | Prosthetics |
| Assistant Surgeon | Hospice | Office Visit | Prostate-specific Antigen (PSA) |
| CAT Scan | Hospital | Pap Smear | Sterilization |
| Chiropractic Services* | Inhalation Therapy | Pathology | Ultrasound |
| Colonoscopy | Laboratory | PET Scan | 23-Hour Observation |
| Consultations | Mammogram | Physical Exam | |
| Dialysis | Medical Supplies | Physical Therapy |
This change does not impact the Federal Employee Program® (FEP®) IVR. Refer to page 5 of the Eligibility and Benefits Caller Guide to view a listing of contained benefit categories within the IVR for FEP members.
* Chiropractic Services Mixed & Therapy will be contained in the IVR as of Jan. 3, 2022.
For additional help with navigating the IVR, refer to the Eligibility and Benefit Caller Guide under the IVR page in the Claims and Eligibility section of our Provider website.
Consider Electronic Options
Checking eligibility and benefits electronically through Availity® or your preferred Web vendor is the quickest way to access information for BCBSTX members. To learn more about online solutions, refer to the Provider Tools section of our website.
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, LLC, 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 provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.
