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Use Simplified Referral Form for American Indian/Alaska Native Limited Cost Share Plans

BCBS Texas·TX·General
Effective date
Jun 3, 2025
We identified it
Jan 12, 2026
Days to comply

Summary

Blue Cross Blue Shield of Texas simplified the Limited Cost-Sharing Referral form for American Indian/Alaska Native members. I/T/U facilities now only need to submit one referral per patient that covers all services for the entire year, and referral provider information was removed from the front page.

Action Required

Action needed
Immediately: Billing staff should use the updated simplified referral form when processing referrals from Indian Health Service, Tribal, and Urban Indian facilities for American Indian/Alaska Native members on limited cost-sharing plans. Ensure all form fields are completed to avoid processing delays.