Welcome providers
We’re a state-contracted health plan that offers Texas Medicaid (STAR and STAR Kids) and Children’s Health Insurance Program (CHIP) services. As a network provider, you get a variety of benefits, from ongoing support and training to formal credentialing and competitive compensation. Together, we can improve health care access and quality.
Already a provider?
Choose helpful links for the most common things providers search for on this page.
Getting started
Here are some helpful provider links if you’re new to our network.
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Find tools and resources for taking care of members, including education on cultural competency and health equity.
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Learn how to request PA and find info on criteria, forms, timelines and referrals.
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Learn more about filing a complaint or an appeal.
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You can find forms, links and other helpful materials and resources right here.
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- Rider 32 Procedure Code List (PDF)
- Provider Notice:Rider 32 Provider Notification Language (PDF)
- Update on Other Insurance (OI) and Coordination of Benefits (PDF)
- Potentially Preventable Conditions for Medicaid (PDF)
- Seperate reimbursement of certain inpatient high-cost drug and biologics (HCCADs) (PDF)
- Provider Enrollment Revalidation Flexibilities (PDF)
Keep your info up to date
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Please update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP at the TMHP Provider Enrollment page your data will be reconciled with the demographic information on file with the MCOs.
To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the Provider Enrollment and Management System (PEMS) web page “Provider Enrollment on the Portal -–The A Step-by-Step Guide” can be accessed for step-by-step instructions for maintenance requests as well as new enrollment, revalidation, and reenrollment. Select the link under Existing Enrollment to access instructions for adding new practice locations or to submit a change of ownership. Select the link under Maintenance to access instructions for updating demographic data. This page also provides links to the Enrollment Help page and the TMHP YouTube Channel. Otherwise, you can contact TMHP directly at 800-925-9126 for assistance.
Keep your information current with Aetna
Keeping your details up to date in our directories helps members find the right info about you and your practice. This also helps ensure that you receive timely payment, communications, reminders and more.
About us
Aetna Better Health® of Texas is part of Aetna® and the CVS Health® family, one of our country’s leading health care organizations. We’ve been serving people who use Medicaid benefits for over 30 years — from kids, adults and seniors to people with disabilities or other serious health issues.
Our national experience helps us do a lot of great work in your community, where you live, work and play. And we’re proud to be your neighbor, working alongside you to make Texas a great state. Members can get the care they need to be as healthy as possible. And they can do it all close to home.
Visit the Aetna Better Health website to learn more.
Let us know what you think
Consider joining our Provider Advisory Group (PAG). You can provide valuable feedback on what’s working and what needs improvement.
Need help or have questions?We’re here for you
Get connected
Find contact info for provider services. Or learn about member helplines, like the 24-Hour Nurse Line and more.
Find more info
You can reach out to your Provider Relations network consultant.
Find your network consultant (PDF)
Other resources
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Learn more about the Texas Health Steps program and how it helps members get the preventive care they need.
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You’ll find more info about the Vendor Drug Program, including how to access the Medicaid formulary and preferred drug list (PDL).
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Learn about available resources to combat Fentanyl.
System outages and downtime
Maintenance activities occur during non-working hours and any downtimes are less than a minute. In the unlikely case of a company-wide outage, you’ll get a notification.
