Blue Cross makes patients’ out-of-pocket health costs available to physicians

Blue Cross and Blue Shield of Texas’ automated systems that give physicians access to member eligibility and benefits will now include information on how much the patient will pay at the time of service, according to an announcement from BCBSTX.

The insurer hopes the added accumulator data will assist physicians’ offices, facilities and other health care professionals in quickly accessing a member’s annual liability amounts that have been met, including amounts met for deductibles, out-of-pocket requirements, lifetime or yearly maximums, and number of visits for both individual and family policies.

The information is accessible through the electronic interactive voice response system and Availity® Web portal. It will also be available via the Blue Cross and Blue Shield Association’s BlueExchange system, which links physicians to benefit information for Texas members seeking services in other states. Other avenues for distributing the information are underway.

A few BCBSTX large groups were excluded during the initial rollout, according to the BCBSTX Office of Physician Advocacy. These physicians may still access eligibility and benefit information through all-access channels, though they will be temporarily directed to contact Provider Services to obtain accumulations. For more information, go to www.bcbstx.com/provider or call (800) 451-0287.