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.
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.
- Changes to the THsteps Therapeutic Dental Benefits
- HEDIS® Data Collection to Begin
- Provider Notification of Unlisted Codes
- Letter to Hospitals, Facilities, Physicians for Clinical with notifications
- Changes to Sterilization Consent Form
- Mosquito Repellent Extension Notice to Providers
- 2016 HEDIS Results
- HEDIS® Documentation Tips for Pediatric Providers
- HEDIS® Tips for Behavioral Health Measures
- HEDIS® Documentation Tips for PCPs
- Texas Health Steps Quick Reference Guide
- Zika Notice for Providers
- Zika Notice for Pharmacy
- MSI Announcement letter
- ADHD Provider Tip Sheet
- Re-enrollment Guidance for Provider
- Removal of Prior Authorization Requirements
- CHIP Cost Sharing Requirements
- CMS 1500 Claim Form
- Humulin Pen Phase Out
- April 2014 Preventive Visit Incentives/Bexar
- March 2014 Preventive Visit Incentives/Tarrant
- February 2014 Preventive Incentives/Tarrant
- Provider Refund Notice
- Speech Therapy Policy Change
- Physical Therapy Policy Change
- Occupational Therapy Policy Change
- Change in CHIP ID's Letter
- Change in CHIP ID's HHSC Communication
- CHIP Cost Sharing Requirements
- Methodist Provider Termination Letter
- Clarification of Reimbursement Rate Change for APRN/PA
- Methodist Provider Termination Reminder Letter
- Rate Reduction
- Modifiers for Deliveries
- Multiple Flu Tests
- ICD-10 CM Coding
- Special Investigative Units
- Additional 1% Reimbursement Reduction
- Immunization Administration Procedure Code Changes
- Grace Period THSteps Screening Tools
- Vitamins and Minerals Added to STAR Formulary
- Grandfathering of Anti-Depressants and Growth Hormones
- ACA PCP Rate Increase
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.
- Spring 2017
- Winter 2016
- Fall 2016
- STAR Kids - Fall 2016
- Summer 2016
- Spring 2016
- Summer 2015
- Winter 2015
- Summer 2014
- Fall-Winter 2013
Providers invited to join our network
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 for members
Cell phones offered to Medicaid members at no cost.