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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 2 Overview of Medicaid Managed Care : 2.2 Provider Enrollment and Responsibilities : 2.2.1 Enrollment, Contracting, and Credentialing

2.2.1
Providers must be enrolled in Texas Medicaid before they can be contracted and credentialed by an MCO or dental plan.
Individual MCOs and dental plans have their own guidelines for contracting and credentialing providers.
Important:
Providers must refer all questions about contracting and credentialing to the MCO or dental plan that administers the clients’ managed care benefits. TMHP does not have access to the contracting and credentialing requirements for the individual MCOs and dental plans.
All questions about Texas Medicaid enrollment can be referred to the TMHP Contact Center.
Note:
Refer to:
Section 9, “* Carve-Out Services” for a list of services that are carved out of the Medicaid Managed Care Program.
Subsection B.1, “Vendor Drug Program”(Vol. 1, General Information) for more information about pharmacy enrollment.

Texas Medicaid & Healthcare Partnership
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