Provider news and updates

For claims processing, please refer to the provider manual.

Whether you are a member or provider, you'll find helpful information and resources within this section of our website.

Update: Affordable Care Act (ACA) Managed Care Organization (MCO) Long Term Services and Supports (LTSS) Provider Enrollment Process

LTSS providers serving managed care members (“MCO LTSS providers”) are required to enroll through the Medicaid MCO LTSS provider enrollment process no later than January 1, 2018. To allow sufficient time for application processing, MCO LTSS providers are strongly advised to submit applications as soon as possible.

Please reference the attached the Q&A document and the Provider Enrollment Crosswalk that identifies the enrollment method for the various provider types and DADS contract types.

ICD-10/Claim Denials

Please be advised that we are seeing claim denials for certain new codes specific to ICD10. We have identified the cause and are working to correct it. Once the correction has been made all impacted claims will be reprocessed. No further action is required at this time on your part.  We apologize for the delay and inconvenience.

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We communicate important information and updates to you in the Aetna Better Health of Texas Provider Newsletter. These newsletters are mailed two times per year, and are always available on the website.  

 

Texas STAR Kids Medicaid Managed Care Program

Aetna Better Health of Texas is recruiting providers to join our network for the new Texas STAR Kids Medicaid Managed Care Program.

Beginning Sept. 1, 2016, children and young adults under the age of 21 who receive Supplemental Security Income (SSI), or receive services through Home and Community-Based Services (HCBS) Waiver programs operated by HHSC, the Department of Aging and Disability Services (DADS), and the Department of State Health Services (DSHS) will receive services through a STAR Kids health plan.

Aetna Better Health of Texas intends to bid to provide STAR Kids services. You are invited to join our network if you meet the following requirements:

  • Must be an attested/ enrolled provider in Texas Medicaid Health Partnership TMHP with a Texas Provider Identifier (TPI);
  • Must have a valid National Provider Identifier (NPI) Number; and
  • Cannot have opted-out of Medicaid or have any sanctions or reprimands by any licensing authority or review organizations.

Requests to join must be submitted by Sept. 8, 2016 for consideration. For more information about participation in the Aetna Better Health of Texas STAR Kids program, call Provider Relations at 1-800-306-8612.

Please also review our submittal process for your letter of interest and prospective provider form.

Cell phones offered to Medicaid members at no cost.