Quick, answer these questions… Which Texas Managed Care Organization (MCO) requires prior auth for a resident evaluation? Which MCO requires number of previous visits for a continued auth? Which MCO prefers that you use fax to submit prior auth requests? If you’re not clear on how to accurately manage the … Read More
All providers must re-enroll in Texas Medicaid by March 24, 2016
If your facility enrolled in Texas Medicaid before January 1, 2013 and currently renders services through Medicaid (MCO or fee-for-service), you must re-enroll in Texas Medicaid by March 24, 2016 to maintain credentialing with your Medicaid managed care network. Texas Medicaid must comply with federal regulations that require providers to … Read More
Texas MCO transition: 3 important things we learned in Week 1
The new STAR+PLUS Managed Care/MCO structure is now a fact of life in Texas. Here are 3 important things we learned during Week 1. 1) SimpleLTC customers are adapting to the new workflow… but still have a ways to go Customers are quickly becoming familiar with the new requirements. Here … Read More
Two ways to simplify Texas Medicaid MCO management
Good news: Texas Medicaid MCO management just got easier Texas providers: Just in time for the Mar. 1 STAR+PLUS MCO managed care transition, we’ve made two significant enhancements to the SimpleCFS™ MESAV process. These changes will help you manage your residents’ MCO information and proactively protect your reimbursement under the … Read More
Less than 5 months until Texas Medicaid managed care transition
March 2015 is quickly approaching, which means that Texas nursing facilities have less than five months to complete their preparations for the transition from fee-for-service to Medicaid managed care (STAR+PLUS). The Texas Department of Aging and Disability Services (DADS) issued a bulletin this week reminding Texas facilities of the looming … Read More