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In order to give the right care for STAR Kids members, Blue Cross and Blue Shield of Texas (BCBSTX) Service Coordinators reach out to parents or Legally Authorized Representatives (LARs) to schedule the SAI. During the SAI, the BCBSTX Service Coordinator will talk about medicine information, services available to the child and diagnoses. You will also talk about any questions you may have. A service coordinator will call you to schedule a time to come out and complete the SAI. Follow these tips to be ready for the SAI: - Plan ahead and write down all your questions for the service coordinator. - Write down a list of all medicine that your child takes. - Write down a list of doctors your child is seeing and any service coordinators or case managers you are working with. - Tell the BCBSTX service coordinator if your child is covered by another health insurance plan or if he or she is on a waiver. - Tell the BCBSTX service coordinator if your child is using any Durable Medical Equipment (DME) or if your child is receiving any kind of other services. Let us help you get the right care You can also have any of the providers or other service coordinators that work with your child present during the SAI interview if you would like. You may also provide your BCBSTX service coordinator with a list of authorized representatives who can speak to the BCBSTX service coordinator on your behalf. While the SAI can take up to four hours, it will allow us to better understand your child’s needs so that he or she will get the right care. Please call your or your child’s BCBSTX STAR Kids Service Coordinator if you have questions at: 1-877-301-4394 or TTY 7-1-1 If you are not able to reach a service coordinator or have other questions, please call our member advocate at 1-855-497-0857. Blue Cross and Blue Shield of Texas complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-710-6984 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-710-6984 (TTY: 711). Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association SKM-1005-17 731450.0517 STAR Kids Screening and Assessment Instrument (SAI)

STAR Kids Screening and Assessment Instrument (SAI)During the SAI, the BCBSTX Service Coordinator will talk about medicine information, services available to the child and diagnoses

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Page 1: STAR Kids Screening and Assessment Instrument (SAI)During the SAI, the BCBSTX Service Coordinator will talk about medicine information, services available to the child and diagnoses

In order to give the right care for STAR Kids members, Blue Cross and Blue Shield of Texas (BCBSTX) Service Coordinators reach out to parents or Legally Authorized Representatives (LARs) to schedule the SAI. During the SAI, the BCBSTX Service Coordinator will talk about medicine information, services available to the child and diagnoses. You will also talk about any questions you may have. A service coordinator will call you to schedule a time to come out and complete the SAI.

Follow these tips to be ready for the SAI:- Plan ahead and write down all your questions for the

service coordinator.- Write down a list of all medicine that your child takes.- Write down a list of doctors your child is seeing and any

service coordinators or case managers you are working with.- Tell the BCBSTX service coordinator if your child is covered by

another health insurance plan or if he or she is on a waiver.- Tell the BCBSTX service coordinator if your child is using

any Durable Medical Equipment (DME) or if your child is receiving any kind of other services.

Let us help you get the right careYou can also have any of the providers or other service coordinators that work with your child present during the SAI interview if you would like. You may also provide your BCBSTX service coordinator with a list of authorized representatives who can speak to the BCBSTX service coordinator on your behalf.

While the SAI can take up to four hours, it will allow us to better understand your child’s needs so that he or she will get the right care.

Please call your or your child’s BCBSTX STAR Kids Service Coordinator if you have questions at: 1-877-301-4394 or TTY 7-1-1

If you are not able to reach a service coordinator or have other questions, please call our member advocate at 1-855-497-0857.

Blue Cross and Blue Shield of Texas complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-710-6984 (TTY: 711).CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-710-6984 (TTY: 711).

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

SKM-1005-17 731450.0517

STAR Kids Screening and Assessment Instrument (SAI)

Page 2: STAR Kids Screening and Assessment Instrument (SAI)During the SAI, the BCBSTX Service Coordinator will talk about medicine information, services available to the child and diagnoses

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

SKM-1005-17

Blue Cross and Blue Shield of Texas complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-710-6984 (TTY: 711).

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-710-6984 (TTY: 711).

731450.0517

Con el objetivo de poder ofrecerles la atención adecuada a los asegurados del programa STAR Kids, los coordinadores de servicio de Blue Cross and Blue Shield of Texas (BCBSTX) se comunican con los padres o representantes legalmente autorizados a fin de programar el instrumento para diagnóstico y evaluación (SAI, en inglés). Durante el SAI, el coordinador de servicio de BCBSTX hablará acerca de medicamentos, servicios disponibles para el niño y diagnósticos. Usted también podrá preguntar lo que necesite. Un coordinador de servicio se comunicará por teléfono con usted para programar un encuentro a fin de completar el SAI.

Prepárese para el SAI siguiendo estos pasos:- Planifique con tiempo y escriba todas las preguntas que

desee formularle al coordinador de servicio.- Escriba una lista de todos los medicamentos que toma su hijo.- Escriba una lista de médicos a los que su hijo acude y los

coordinadores de servicio o profesionales clínicos asignados al caso con los que usted trabaje.

- Hágale saber al coordinador de servicio de BCBSTX si su hijo está cubierto por otro plan de seguro médico o si está exento.

- Hágale saber al coordinador de servicio de BCBSTX si su hijo usa equipo médico duradero o si recibe cualquier otro tipo de servicios.

Lo ayudamos a encontrar la atención que necesitaSi lo desea, puede solicitarle a cualquier proveedor o coordinador de servicio de su hijo que esté presente durante la entrevista del SAI. También puede entregarle al coordinador de servicio de BCBSTX una lista de representantes autorizados a hablar en su nombre para que puedan conversar con el coordinador.

Aunque el SAI puede demorar hasta cuatro horas, nos permitirá comprender mejor las necesidades de su hijo para que obtenga la atención que necesita.

Si tiene preguntas, comuníquese con su coordinador de servicios del programa STAR Kids de BCBSTX o con el de su hijo al 1-877-301-4394 (TTY 7-1-1).

Si tiene problemas para comunicarse con un coordinador de servicios o tiene otras preguntas, comuníquese con un Especialista en Servicio al Cliente al 1-855-497-0857.

Instrumento para diagnóstico y evaluación de STAR Kids