After contacting the Managed Care Organization (MCO) or Dental Maintenance Organization (DMO), the MCO will confirm your provider status and notify Aperature, who administers the Credentialing Verification Organization (CVO), to begin the credentialing process.
The Texas Association of Health Plans (TAHP) in collaboration with the Texas Medical Association (TMA) and HHSC contracted Managed Care Organizations (MCOs) are excited to announce a joint effort to reduce credentialing burdens for all Texas providers, including physicians, hospitals, DME providers, facilities and all types of ancillary providers, including nursing facilities and other long-term services & supports (LTSS). TAHP and TMA selected Aperture Credentialing, LLC, to manage a statewide Credentialing Verification Organization (CVO) contract used by all Medicaid and CHIP MCOs in Texas to streamline the provider credentialing process. While commercial MCOs are not yet required to use the CVO, the Texas Credentialing Alliance's goal is to expand use of the CVO to them. The initiative fulfills the long-time, mutual goal of helping reduce administrative barriers and costs. Dental Maintenance Organizations (DMOs) will begin using the CVO in January 2020.
Providers will continue directly contacting the plan(s) they wish to contract with but credentialing applications will only need to be submitted to Aperture, the CVO. The MCO(s) will notify Aperture to begin the credentialing process with you. Aperture will contact providers to start the credentialing process, accept the credentialing application and perform the primary source verification (PSV), which includes verification of provider application, license and all applicable licenses/documents.
The MCOs have also partnered to achieve simplification with a soon-to-be released single facility application. Under this application, all Texas MCOs will use the same applications, and providers will not need to maintain different facility credentialing applications for each MCO. The Council for Affordable Quality Healthcare (CAQH) will remain available for practitioners and health care professionals who currently use it, and a new solution will be offered for ancillaries and facilities through Availity beginning April 2018. Paper applications will continue to be accepted by Aperture.
The credentialing process is separate from the contracting process. Providers will need to engage with the MCO(s) for contracting needs and provide any additional information to complete the credentialing process.
Providers enrolling in Texas Medicaid and CHIP through Texas Medicaid & Healthcare Partnership (TMHP) must continue following the processes as provided by TMHP/HHSC. Providers must also complete the enrollment process through TMHP/HHSC prior to credentialing with the MCO(s).
Some provider types qualify for expedited credentialing. Expedited credentialing allows qualified providers to provide Medicaid services on a provisional basis while the credentialing application is pending. Expedited credentialing does not shorten the length of time it takes for CVO to process an application. If the provider qualifies for expedited credentialing, MCOs/DMOs will process claims from providers within 30 calendar days after receipt of a complete application, even if the CVO's review of the provider’s credentialing application is still ongoing.
The following provider types may participate in the expedited credentialing process:
To qualify for expedited credentialing, a provider must:
Aperature Contact Information
1-800-398-0335, choose Option 3
Availity Contact Information
1-800-AVAILITY (1-800-282-4548)
Introduction to the Texas Credentialing Verification Organization⎪March 1, 2018
Introduction to the Availity Portal and Credentialing Preview for TAHP Providers⎪April 4, 2018
For Nursing Facilities: Nursing Facility Credentialing through the CVO
For LTSS Providers: Credentialing on the Availity Portal
For Hospitals: Credentialing on the Availity Portal for TAHP Providers
Aperture is the nation’s largest Credentialing Verification Organization providing services to some of the largest payer and provider organizations in the country. Aperture operates nationwide and also manages several other national, state-based and specialty-based unified credentialing programs. Aperture is National Committee for Quality Assurance (NCQA) Certified and Utilization Review Accreditation Commission (URAC) Accredited for more than 10 years.
Availity is a credentialing application portal that will be used in the implementation of the Credentialing Verification Organization (CVO). All MCOs will be using Availity for submission of the non-practitioner (facility) application. We have five current MCOs who will also be using Availity for their practitioner applications:
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