Provider News Feed

Beginning May 30, 2025, the Provider Enrollment and Management System (PEMS) will be enhanced to streamline the process for Texas Medicaid enrollment and managed care organization (MCO) and dental maintenance organization (DMO) credentialing. The new feature will allow a provider to complete and submit their credentialing information as part of the enrollment process, the reenrollment process, or as a maintenance request. Learn more about the key features of this enhancement to the process for Texas Medicaid enrollment on the Texas Medicaid and Healthcare Partnership's website.

MCNA is hosting the following online webinar training sessions:

April 29, 2025

• 11:00am or 1:30pm: CHIP Presentation

May 27, 2025

• 11:00am or 1:30pm: Submission of X-rays, Narratives, and Photos

June 24, 2025

• 11:00am or 1:30pm: General Anesthesia Cases for Members Aged 6 and Under

Please visit our Provider Training Webinars page to RSVP at least 24 hours before the scheduled webinar to ensure that you receive an invite. For questions, please contact the MCNA Provider Hotline at 1-855-776-6262.

The U.S. Department of Health and Human Services Office of Inspector General (OIG) has released an important notice about a fraud scheme with the potential for large losses. In the scheme identified by OIG, fraudsters diverted Federal and State payments intended for providers participating in the Medicare and Medicaid programs. Please access the full Fraud Survey Report on OIG's website to learn more.

The next issue of MCNA’s provider newsletter, Dental Details, is now available! Check your email or download the latest issue.

In this issue:

• Celebrating National Dentist’s Day and Dental Hygienists’ Week

• Emerging Technologies in Dental Care

• Preparing for Tax Season

• How to Build a Strong Dental Team

• Question of the Quarter

If you are not subscribed to receive the newsletter each quarter, you can easily sign up by clicking “Manage Your Mailing List” in your Provider Portal account. We also recommend that you check your Mailing List periodically to ensure the email addresses for your office are up-to-date.

Our Provider Quick Reference Guide contains helpful contact information and tips and has been updated to v1.5. Download your copy today at https://docs.mcna.net/guides/qrg-tx.

Version 1.27 of the Texas Medicaid and CHIP Provider Manual is now available. This version contains updated Medicaid covered service rates in alignment with the HHSC comprehensive code review effective March 1, 2025. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.

Version 1.26 of the Texas Medicaid and CHIP Provider Manual is now available. You will find a summary of the changes in the Revision History located at the back of the manual. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.

Version 1.25 of the Texas Medicaid and CHIP Provider Manual is now available. You will find a summary of the changes in the Revision History located at the back of the manual. We encourage you to download a copy of the new Texas Provider Manual today at https://manuals.mcna.net/texas.

MCNA's updated Provider Relations (PR) Territory Map tells you which of our skilled PR team members is dedicated to your office and puts other important contact information at your fingertips. Get your copy of our guide Contact Information for Provider Relations Representatives by Territory today.

MCNA is hosting the following online webinar training sessions:

January 28, 2025

• 11:00am or 1:30pm: Submission of X-rays, Narratives, and Photos

February 25, 2025

• 11:00am or 1:30pm: General Anesthesia Cases for Members Aged 6 and Under

March 25, 2025

• 11:00am or 1:30pm: Corrected Claims Process

Please visit our Provider Training Webinars page to RSVP at least 24 hours before the scheduled webinar to ensure that you receive an invite. For questions, please contact the MCNA Provider Hotline at 1-855-776-6262.