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Update to ERS Prior Authorization of Outpatient Surgeries

December 29, 2017

A change has been made to the Prior Authorization Lists, retroactively back to Sept.1, 2017, to no longer require prior authorization for outpatient surgery in the office setting for participants in the Employee Retirement System of Texas’ (ERS) HealthSelectSM of Texas, Consumer Directed HealthSelectSM and ERS Out-of-State Plans. Please refer to the Prior Authorization Lists on the Clinical Resources page of bcbstx.com/provider for the updated prior authorization requirements. Office surgery claims are currently being re-adjudicated if they were previously denied for no prior authorization. No action is needed by the providers for the previously submitted claims.