Posted 08/02/2024 Updated 10/03/2024, 10/29/2024
Note: Added CERIS Overview and FAQ
In addition to post pay audits already in place for the Employees Retirement System of Texas (ERS) participants, pre-payment reviews will be implemented for improved facility claim billing and payment accuracy.
CERIS, who currently performs post pay audits on behalf of Blue Cross and Blue Shield of Texas, will soon begin pre-payment claim reviews for ERS plan participants. This may help avoid refund requests handled post-pay.
As a part of the pre-pay review process, CERIS may request documentation such as an itemized bill in order to conduct the review. Documentation should be submitted to the address listed on the request letter from CERIS, not to BCBSTX.
For additional information regarding the pre-pay review performed by CERIS on behalf of BCBSTX, refer to the CERIS Overview and a FAQ on the ERS Tools page.
CERIS, a CorVel Health Corporation, is an independent company contracted with Blue Cross and Blue Shield of Texas to provide medical claim audits for members with coverage through BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.