MedicaidPrior AuthHigh impact
Learn About Enhancements to Medicaid Utilization Management Process, Effective Sept. 18, 2026
BCBS Texas·TX·Prior Authorization
Effective date
Sep 18, 2026
We identified it
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.
Action Required
By Sept. 18, 2026: Billing team must transition all Texas Medicaid prior authorization workflows to the new Medicaid Authorizations application in Availity Essentials. (1) Ensure staff access Availity and are registered for at least one training webinar (Sept. 14–17, 2026) to learn navigation, member search, code selection, and documentation upload procedures. (2) Update internal processes to initiate authorization requests through Availity Authorizations & Referrals by selecting 'Texas Medicaid' as the payer, or access via Availity Payer Spaces. (3) Train billing staff to leverage real-time authorization checks, draft-saving functionality, and online letter tracking to eliminate manual phone/fax submissions. (4) Discontinue legacy paper-based and fax-based authorization request methods for BCBSTX-handled Medicaid cases. Failure to transition may result in processing delays and claim denials. Note: Availity user credentials are required for webinar registration and system access.