To help manage a backlog of revalidation applications stemming from the transition to Medicaid’s new Provider Enrollment Management System (PEMS), the state’s Medicaid claims payment contractor announced it will extend revalidation timeframes for physicians and other health care practitioners and suspend disenrollments related to that process.

Are You Eligible for “Expedited Credentialing?” - 09/23/2020

If you’re completing health plan credentialing, “expedited credentialing” might apply to you. And if it applies, that could be good for you and your practice. But how do you know if it does?

Physicians Needed for Medicaid Managed Care Advisory Panel - 03/03/2020

March 13 is the new deadline to get your application to the Texas Health and Human Services Commission if you want to serve on its State Medicaid Managed Care Advisory Committee. The panel advises the commission on Medicaid managed care operations statewide.

Make Medicaid Managed Care More Efficient - 04/09/2019

HB 4178 is the culmination of work by physicians, hospitals, and health plans to reduce Medicaid red tape. Physicians feel heavily burdened not only by the number of prior authorizations they must complete but also the complexity of the process. The system must be reformed to make it more accountable, transparent, and simpler.

Medicaid Eligibility Verification Website to Be Shuttered Friday - 12/13/2018

The Texas Health and Human Services Commission (HHSC) will decommission the YourTexasBenefitsCard.com website and the Medicaid eligibility verification Interactive Voice Response system at 7 pm (Central) on Friday.

Summit Seeks Medicaid Improvements - 10/22/2018

Physicians, hospital administrators, and health plan executives gathered at the Texas Medical Association building last week in search of common ground to improve the state’s Medicaid system.

Guidelines for Medicaid Radiology Prior Authorization - 05/03/2018

Texas Medicaid requires prior authorization for outpatient diagnostic radiology services. Follow these guidelines to help you sail through the process.

Health Care Coverage for Low-Income Texans - 02/03/2017

Medicaid and the Children’s Health Insurance Program (CHIP) cover more than 4 million low-income Texans. That includes half of all children in the state and about two-thirds of people in nursing homes. As the Texas Medical Association has long cautioned, however, a Medicaid card does not equal access to health care. Extremely poor payment rates and extraordinarily high bureaucratic burdens lead most Texas physicians either to refuse to accept all new Medicaid patients or to limit the numbers they can see. TMA encourages the Texas Legislature to increase Medicaid and CHIP payments and reduce administrative hassles, and to search for creative new ways to provide more health insurance coverage for low-income Texans.

Nationwide Credentialing - 10/20/2016

Credentialing with the government and health insurance companies continues to be a complex and time-consuming for practices of all sizes. At Nationwide Credentialing, we work with you from start to finish on the credentialing process, which allows physicians and their staff to focus on patients and other important aspects of their practice.

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