Nursing Facility Provider Credentialing

Nursing Facility Provider Credentialing

To participate as a STAR+PLUS network provider nursing facility providers must be credentialed. Even though the deadline for MCOs of Aug. 31, 2019 has passed, credentialing is continuing for all NF providers.

The MCOs send three requests for application information with 60 days between each. All NF providers should have received at least one of these requests and must respond to the MCO as soon as possible. MCOs can take contractual actions against NF providers who don’t complete the credentialing application after the third request.

Providers that submitted a complete application by July 31, 2019 are credentialed if the NF provider is Medicaid-certified, licensed by HHSC, and remains contracted with HHSC until the credentialing process is complete. Completion of the credentialing process can take place after Aug. 31, 2019 if the above is true.

The Texas Association of Health Plans created a resource guide for credentialing NF providers who have recently undergone a change of ownership. This guide also has contact information for each STAR+PLUS MCO.

NF providers should immediately contact the MCOs operating in their service area if they have not received a credentialing application request, or do not know if they are credentialed.