BCBS Resources

Learn more about our health plan in partnership with BCBS, including resources for claims and authorizations such as PCP claims, specialist/ancillary/facility claims, and referrals/authorizations.

PCP/Specialist/Ancillary/Facility Claims Referral/Authorizations

PCP/Specialist/Ancillary/Facility Claim Options

  • EDI

To submit your EDI through your Clearinghouse, use the Payer ID: 66006.

  • Submit Through Availity

1. Log in to Availity

2. Go to Claims & Payments

3. Select the correct claim type: Professional or Institutional

4. Choose BCBSTX Medicare Advantage as the payer

5. Enter all required claim details and submit

Referral/Authorization Steps

To submit an authorization request to BCBSTX, follow these steps:

  1. Log in to Availity Essentials (free provider portal).
  2. Navigate to Patient Registration → Authorizations & Referrals → Authorizations (or Referrals for referral-only submissions).
  3. Select the payer: BCBSTX, then choose your provider organization.
  4. Choose the appropriate type of request (e.g., inpatient, outpatient, referral).
  5. Enter all required member and clinical information, including:
  6. Member ID
  7. Date of Birth
  8. Diagnosis and procedure codes
  9. Dates of service
  10. Submit the request and retain the confirmation/authorization number.

Providers can also use Availity Essentials to check the status of requests and update existing authorizations or referrals.

For assistance, contact Provider Services at 1-877-774-8592, available Monday–Friday, 8 a.m.–5 p.m., excluding state‑observed holidays.

For additional resources and detailed instructions, visit the BCBSTX provider website or contact their Provider Services team.