TSO Network Update -February 2018

18 l February 2018 Insurance & Third Party — Contact Cindy Huynh at Cindy@tso.com about Insurance & Third Party questions. How to Update Data About Your Office To update your office’s demographic information, go to our secure provider website and sign in. You should notify us whenever the following information changes: • Email and mailing addresses • Phone or fax numbers • Name changes due to marriage or another life event • Whether your office is accepting new patients • Hospital and group affiliations If you’ve been calling our Provider Service Center to make these changes, we ask you to use the secure provider website instead. The site lets you confirm the information you submit. It also prevents unauthorized individuals from submitting incorrect information about your office or facility. The Centers for Medicare & Medicaid Services (CMS) requires Medicare Advantage plans and Qualified Health Plans (QHPs) to maintain accurate directories. Having your up-to-date information allows us to do that. Electronic transactions You also can do most electronic transactions through the secure provider website. This includes submitting claims, checking patient benefits and eligibility, and requesting precertifications. NaviNet security officers have access to Aetna’s “Update Provider Demographics” function, through which they can submit demographic changes. They also can authorize other users’ access to this feature as appropriate. To use the secure website, you must register first. We Offer a New Plan in the Dallas-Forth Worth Market Aetna and Texas Health Resources have established a jointly owned health plan called Texas Health AetnaSM. The plan is available to employer groups based primarily in the Dallas-Fort Worth area. You should verify eligibility before seeing a member in Texas Health Aetna. Some plan options under Texas Health Aetna offer a limited network. Not all Aetna providers are part of this network. Aetna administers the Texas Health Aetna planSM. This means Aetna policies and procedures apply to their members. Here are some things you should know: • Your Aetna fee schedule applies to these members unless you signed a direct contract with Texas Health Aetna. • Texas Health Aetna members have their own ID card. • You should submit claims using payer ID 88221 and use the address on the back of the member ID card. Use the Aetna secure provider website for online transactions and tools for Texas Health Aetna, as well as to access member ID cards. For more information: • Visit the Texas Health Aetna website • Call the number on the Texas Health Aetna member’s ID card