2.2.1

Enrollment, Contracting, and Credentialing

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:

Enrollment in Texas Medicaid does not guarantee that an MCO or dental plan will contract or credential a particular provider.

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:

Providers who render only carve-out services are not required to contract with Medicaid MCOs and dental plans.

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.