BCBS TexasHigh ImpactAdministrative

Follow Guidelines for Making Physician Referrals for HMO Members

Published January 12, 2026Effective July 29, 2025

AI Summary

Blue Cross Blue Shield of Texas has updated referral procedures for HMO members enrolled in Blue Advantage HMO, Blue Advantage Plus HMO, Blue Essentials, and My Blue Health plans. Providers must now call the customer service number on the member ID card to request referrals, with processing times of 5 business days for standard requests and 24 hours for urgent requests.

Action Required

Immediately: All staff handling referrals must update procedures to call the customer service number on the member ID card for all Blue Advantage HMO, Blue Advantage Plus HMO, Blue Essentials, and My Blue Health referral requests. Provide initial request ID and detailed explanation for additional review. Allow 5 business days for standard requests and 24 hours for urgent requests. Update referral tracking system to accommodate new processing timeframes.

Plan Types

Commercial

States

TX

Specialties

all-specialties