TMPPM 2008 > Provider Information > Managed Care > NorthSTAR Program

   
 

7.4.4 Client Enrollment

When a Medicaid enrollee requests services, the provider should contact ValueOptions or the enrollment broker to verify enrollment in NorthSTAR. If the client is not currently enrolled in NorthSTAR, the provider may give the client the telephone number of the enrollment broker so the client may become enrolled in NorthSTAR.

The enrollment broker staff is trained to assist potential clients in their understanding of both the STAR and NorthSTAR programs.

Medicaid clients must enroll via the enrollment broker if during regular working hours. If it is an emergency and after regular business hours, the NorthSTAR BHO can enroll a Medicaid client into NorthSTAR.

Medicaid clients may also mail in the enrollment using the NorthSTAR enrollment form. Non-Medicaid clients may be enrolled by NorthSTAR at designated enrollment sites.

Client enrollment is retroactive to the NorthSTAR eligibility certification date. Example:

NorthSTAR Example

Client certified for Texas Medicaid in the NorthSTAR SA

January 1

Medicaid benefits begin

January 1

Client enrolls in NorthSTAR

January 20

NorthSTAR benefits begin

January 1


Texas Medicaid & Healthcare Partnership
CPT only copyright 2007 American Medical Association. All rights reserved.
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