BCBS TexasLow ImpactAdministrative

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

Published January 12, 2026Effective June 3, 2025

AI 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

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.

Plan Types

Commercial

States

TX

Specialties

all-specialties