Provider news and updates
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Provider Advisory Group (PAG)
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Providers serve in advisory roles on a variety of Aetna’s committees both locally and nationally, providing invaluable feedback on strategies for improving member care and services. In Texas, contracted STAR/CHIP providers from all service areas may participate in our established and active PAG.
Our Texas PAG currently consists of providers from the Bexar and Tarrant service areas. We will work to ensure participation and representation by providers from each service area we have the privilege of serving. The PAG consists of representatives from the following provider types: acute care, pharmacy, family practice, pediatrics, obstetrics and gynecology, psychiatry, and nurse practitioners.
If you are interested in joining our PAG, please contact your Provider Relations Representative and someone from our leadership team will contact you to discuss further.
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Provider Notices
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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.
2020
- Expanded services with Equian, Cotiviti and Optum
- How to File a Complaint
- THSteps Reminder
- ABH Prior Authorization Effective 9/1/20 (new)
- Survey to Identify Substance Use Screening and Referral Practices for Pregnant and Postpartum Women
- New Policy Updates for STAR Kids and eviCore for Prior Authorization effective 09012020 (New)
- Project ECHO
- New Policy Updates Clinical Payment, Coding and Policy Changes 9/1/2020
- New Policy Updates Clinical Payment, Coding and Policy Changes
- STAR, STAR Health: COVID-19 and Applicability of EPSDT for Some Adultsin STAR and STAR Health (New)
- Housing Choice Survey
- Data Quality Issues Experienced by MCOs via Texas Immunization Registry
- Instructions for Electronic Funds Transfer (EFT) Enrollment
- Instructions for Electronic Remittance Advice (ERA) Enrollment
- Beginning May 1, 2020, Medicare-Enrolled Speech-Language Pathologists May Apply to Enroll as Texas Medicaid Providers
- Aetna Better Health® of Texas Claim Submission Instructions Change Notice – Service Facility Address on NICU Claims
- Notice to Physicians and Providers
- ABH Electronic Authorization New Electronic Prior Authorization Submission Tool Quick Reference Guide
- Aetna Better Health of Texas’s Provider Web Portal
2019
- Beginning December 14, 2019, Opioid Treatment Providers May Submit Texas Medicaid Enrollment Applications
- Clinical Laboratory Improvement Amendments (CLIA) requirements on Claim Effective 01-10-2020
- Inform Providers 2012 American Dental Association Claim Form can not to be used after Dec. 31, 2019
- Eteplirsen to become a Benefit in the Home Setting Effective December 1, 2019
- Providers Required to Use 2018 and 2019 American Dental Association Claim Forms by Jan. 1
- Aetna Better Health® Webinar Series Schedule
- Inform Texas Health Steps Providers that the DSHS Laboratory Web Portal is Not Available by Nov. 18
- Save the Date for FMSA Annual Training on Oct. 21
- Congenital Syphilis Health Advisory
- Inform Providers About the Time Limit for Use of the 2012 American Dental Association Claim Form to under 2019
- Medication Assisted Treatment Benefits to Change for Texas Medicaid November 1, 2019
- Updated Version of the American Dental Association Claim Form Now Available
- Summary of smoking cessation benefits in Medicaid and CHIP
- Diagnosis Code Guidelines-icd10 Excludes 1 Notes 06122019
- Hello to Health (English|Spanish)
- Claim Filing Instructions Change Notice – Provider Taxonomy
- Reminder: Changes to Sterilization Consent Form, Instructions, and Denial Letter Effective April 26, 2019
- LARC Notice
- Texas Partnership for Out of School Time (TXPOST)
- Important Guidance Regarding MCO LTSS Provider Enrollment - MCO Credentialing is Not Equivalent to Medicaid Enrollment
2018
- HEDIS Results 2018 (CHIP)
- HEDIS 2018 Results (STAR)
- Final LTSS Enrollment Notification
- Acceptable and Not acceptable as an MSRP/Invoice
- Therapy Wait List
- Prior Authorization (PA) Change notice
- MCO LTSS Quick Tips
- Antibiotic Stewardship CME
- Antibiotic Stewardship News you can use
- Texas Credentialing Alliance Alert & Reminders about CVO Process & Availity Portal
- Updated Provider Information Change Form Now Available
- First PPECC Medicaid Enrolled Provider, and PPECC Type and Place of Service
- Aunt Bertha - Get information about local programs. Aunt Bertha makes it easy to get the help you need.
- Aetna Provider Notification_Facility Emergent ER effective 06012018
- WIC and Postpartum Depression resources
- Clarification for Providers Regarding MCO Therapy Guidance
- SUBSTANCE USE AND DOMESTIC VIOLENCE WEBPAGE RESOURCE
- Wound Equipment and Supply Benefits Change July 1 2018
- LEAD EXPOSURE SCREENING AND TREATMENT PROVIDER EDUCATION
- Access to Care Guidelines
- 5-17-2018 Update Aetna Better Health Provider Letter – Delivery Claim Billing Effective Feb 1 2018
- Dental Anesthesia – Clinical Payment, Coding and Policy Changes
- Opioid Strategy
- NICU Visit Policy Change rev
- CHIP Member Eligibility Now Available via EDI HIPAA X12 270 and 271 Transaction
- LOI Letter to Facility
- Private Duty Nursing Policy Language Clarification
- AIM Maternal Safety Bundles in Texas
- Texas AIM Flyer March Webinar
- ABH Delivery Claim Billing eff 2/1/2018
- Delivery Group 1 – Full codes
- Mayo Pathways Diversity 2018 Final
- Mayo Clinic Diversity Summit
- Update to the TMPPM Gynecological, Obstetrics and Family Planning Handbook for LARC and Immediate Postpartum LARC Devices
- LARC Quick Course
- HEDIS Training Webinar Series
- Small Alternative Device Alert
- Texas Resiliency and Recovery Utilization Management Guidelines (TRRUMG)
2017
- HEDIS Training Webinar Series
- Project ECHO Training
- Practice requirements related to telemedicine services
- CHIP Provider Reenrollment
- Private Duty Nursing Benefit Language Clarified for Texas Medicaid Effective January 1, 2018
- Reminder THSteps Procedures and Documentation
- Child Developmental Screening and Surveillance Web Training
- WCC Article Cover Letter HEDIS Educational Flyer
- WCC Provider Education Flyer -2017
- Medicaid Fraud Notice
- 10-4-17 Upcoming CHIP Provider Enrollment Webinar
- TexasBenefitsCard.com Provider Portal Tutorial
- Breastfeeding Support Services to Change for Texas Medicaid on September 1 2017
- Therapies Policy Changes FAQ HHSC
- Improved Access to Breast Pumps Effective September 1, 2017 for Texas Medicaid
- THSteps Provider Notice - DSHS Lab Specimens Hurricane Harvey
- Texas Medicaid Standing Order for Mosquito Repellent
- Physical, Occupational, and Speech Therapy Benefit Changes Effective September 1, 2017
- Changes to the THsteps Therapeutic Dental Benefits
- Provider Notification of Unlisted Codes
- Letter to Hospitals, Facilities, Physicians for Clinical with notifications
2016
- Obstetric delivery claim filing update
- Changes to Sterilization Consent Form
- Mosquito Repellent Extension Notice to Providers
- Texas Health Steps Quick Reference Guide
- Zika Notice for Providers
- Zika Notice for Pharmacy
2015
- MSI Announcement letter
- ADHD Provider Tip Sheet
- Re-enrollment Guidance for Provider
- Removal of Prior Authorization Requirements
2014
- 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
2013
- 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
2012
2011
- 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
2010
2008
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Provider Newsletters
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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.
- Winter 2020
- Spring 2020
- Fall 2019
- Summer 2019
- Spring 2019
- Winter 2019
- Fall 2018
- Summer 2018
- Spring 2018
- Fall 2017
- Summer 2017
- Spring 2017
- Winter 2016
- Fall 2016
- STAR Kids - Fall 2016
- Summer 2016
- Spring 2016
- Summer 2015
- Summer 2014
- Fall-Winter 2013
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Cell phones for members
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Cell phones offered to Medicaid members at no cost.