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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 7 STAR Health Program : 7.3 STAR Health Program Benefits

STAR Health Program clients receive all the benefits of traditional Texas Medicaid as well as service coordination to assist in making appointments and accessing services; and service management to assist with managing the health care of those with ongoing and serious medical needs.
Refer to:
“Appendix B: Vendor Drug Program” (Vol. 1, General Information) for information about outpatient prescription drugs.
Most Medicaid foster care claims are capitated services and must be submitted to Superior HealthPlan.
Refer to:
Section 9, “* Carve-Out Services” in this handbook for the list of non-capitated services that may be reimbursed by TMHP.
All THSteps dental, medical, vision, and mental health providers should submit claims for services rendered to foster care clients to Superior HealthPlan’s dental, vision, and mental health contractors.
For general provider information, contact STAR Health at 1-866-439-2042.
For authorizations, contact:
(Fax 1-800-690-7030)
(Fax 1-866-534-5958)
(Fax 1-252-451-2140)
12121 North Corporate Parkway
Mequon, WI 53092
HIPP program clients who are enrolled in STAR HEALTH should be removed from the HIPP program and continue to receive their benefits under the STAR Health program.
Refer to:
Subsection 4.12, “Health Insurance Premium Payment (HIPP) Program” in Section 4, “Client Eligibility” (Vol. 1, General Information), for more information about outpatient prescription drugs that are provided by VDP contracted pharmacies.
“Appendix B: Vendor Drug Program” (Vol. 1, General Information) for information about VDP.

Texas Medicaid & Healthcare Partnership
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