Hospital/Facility Based Medical Group Provider Language Attachment

Effective January 1, 2018 the Hospital Based Medical Group Provider Language Attachment that was part of the Blue Cross Blue Shield of Texas (BCBSTX) Agreement(s) for Facility Based Providers will be deleted in its entirety and will no longer be valid. This attachment details the contractual items that pertain to providers who only render services in a hospital/facility setting.

This disclosure notification applies to the networks listed below. If you are a Facility Based Provider in one or more of these networks this notification applies to you:

• Blue Choice PPO^SM
• Blue Essentials^SM
• Blue Premier^SM
• Blue Advantage HMO^SM

Please note that effective January 1, 2018, there will be updates to the preauthorization list that could impact your specialty. We urge you to review the list of services that require preauthorization by referring to the Preauthorization/Referral Requirements list located in the Clinical Resources section of the BCBSTX provider website.

If you have any questions regarding this disclosure notification, please contact your Network Management Representative.