Medicaid HMO Credentialing – and Recredentialing – Just Got Easier
By Sean Price

Credentialing_update

Starting this week, Texas physicians can save time getting credentialed and recredentialed for Texas' 19 Medicaid managed care plans.

A new collaboration by the Texas Medical Association and the Texas Association of Health Plans (TAHP) called the Texas Credentialing Alliance has streamlined a process that has long frustrated physicians because of its bureaucratic redundancy. 

In the past, physicians who wanted to accept all 19 participating Texas Medicaid plans had to fill out 19 separate credentialing applications, which could be up to 40 pages long each. Physicians will still contact plans they’re interested in, but now will fill out one central application for those plans to use, said Jamie Dudensing, CEO of TAHP, the statewide trade association representing health insurers. The program will be administered by Aperture Credentialing LLC. 

The biggest benefit will come when physicians renew their credentials ― or recredential ― with each plan. Previously, physicians faced up to 19 separate renewal deadlines. Under the Texas Credentialing Alliance, each doctor will have a single recredentialing deadline once every three years. 

“Anything that cuts through Medicaid’s tangled web of red tape is good for Texas physicians and good for our patients,” said TMA President Carlos J. Cardenas, MD. “The centralized credentialing organization should cut away a big knot of Medicaid hassles. We are excited about its launch.”

For more details, check out this TAHP slide deck from a recent Texas Credentialing Alliance webinar for physicians.


Last Updated On

April 03, 2018

Sean Price

Reporter

(512) 370-1392

Sean Price is a reporter for Texas Medicine and Texas Medicine Today. He grew up in Fort Worth and graduated from the University of Texas at Austin. He's worked as an award-winning writer and editor for a variety of national magazine, book, and website publishers in New York and Washington. He's also helped produce Texas-based marketing campaigns designed to promote public health. Sean lives in Austin and enjoys hiking, photography, and spending time with his wife and two sons.

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