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BCBS TexasCommercial · Administrative · General · TXHigh impact

Follow Guidelines for Making Physician Referrals for HMO Members

Act
immediately
Effective date
Jul 29, 2025
Identified
Jan 12, 2026

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.

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What to do

immediately · 4 steps
01All 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.
02Provide initial request ID and detailed explanation for additional review.
03Allow 5 business days for standard requests and 24 hours for urgent requests.
04Update referral tracking system to accommodate new processing timeframes.

Original notice

Follow Guidelines for Making Physician Referrals for HMO Members
bcbstx.com · Always check the source before changing claims.
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