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BCBS TexasMedicaid · Prior Auth · Prior Authorization · TXHigh impact

Learn About Enhancements to Medicaid Utilization Management Process, Effective Sept. 18, 2026

Effective date
Sep 18, 2026
Identified
Aug 15, 2026

Summary

Blue Cross and Blue Shield of Texas is launching a new Medicaid Authorizations application within Availity Essentials effective Sept. 18, 2026, streamlining prior authorization and notification requests for Texas Medicaid members. Billing teams will now check authorization requirements in real-time, submit requests 24/7, upload documentation online, and track status immediately through an integrated workflow—replacing traditional phone, fax, and paper processes.

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What to do

Action · 9 steps
01By Sept.
0218, 2026: Billing team must transition all Texas Medicaid prior authorization workflows to the new Medicaid Authorizations application in Availity Essentials.
03Ensure staff access Availity and are registered for at least one training webinar (Sept.
0414–17, 2026) to learn navigation, member search, code selection, and documentation upload procedures.
05Update internal processes to initiate authorization requests through Availity Authorizations & Referrals by selecting 'Texas Medicaid' as the payer, or access via Availity Payer Spaces.
06Train billing staff to leverage real-time authorization checks, draft-saving functionality, and online letter tracking to eliminate manual phone/fax submissions.
07Discontinue legacy paper-based and fax-based authorization request methods for BCBSTX-handled Medicaid cases.
08Failure to transition may result in processing delays and claim denials.
09Note: Availity user credentials are required for webinar registration and system access.

Original notice

Learn About Enhancements to Medicaid Utilization Management Process, Effective Sept. 18, 2026
bcbstx.com · Always check the source before changing claims.
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