[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-283937-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-283937-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","texas-mco-prior-authorizations-webinar-slides-2015","Texas MCO Prior Authorizations Webinar Slides - 2015","","Texas provider guidance on prior authorization workflows focused on the Texas Standard Prior Authorization Request Form, the MMP Prior Authorization process, and how to use the MCO Prior Auth Crosswalk to streamline required submission details. Covers what Texas health benefit plan issuers must accept starting Sept. 1, 2015, identifies key items needed on the prior auth form (DX code, CPT, frequency, duration, number of visits, and start/end dates), and explains how MCO plan codes map across MESAV service areas. Includes instructions for creating prior auth forms in SimpleCFS.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/presentations/","Presentations",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/texas-mco-prior-authorizations-webinar-slides-2015/283937/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/texas-mco-prior-authorizations-webinar-slides-2015/283937.png","ImageObject",442,249,{"name":42,"@type":43},"Taylor Morgan","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-03","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the Texas Standard Prior Authorization Request Form used for?","Question",{"text":63,"@type":64},"Health benefit plan issuers must accept the Texas Standard Prior Authorization Request Form when prior authorization is required for a health care service starting Sept. 1, 2015.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which information items are required on the prior authorization form for the MCO crosswalk?",{"text":68,"@type":64},"The required items include DX code, treatment CPT code, frequency, duration, number of visits requested, and start and end dates.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the MMP prior authorization process work at a high level?",{"text":72,"@type":64},"It involves reviewing the MMP skilled nursing facility quick reference document, reviewing the prior authorization request form, and reviewing prior authorization criteria for Part A/SNF admissions.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},283937,1791722305,{"code":4,"msg":82,"data":83},"success",[84,88,92,97,102,107,112,117,122],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":86,"slug":87},11,90,"presentations",{"id":55,"doc_module":22,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Resumes",80,"resumes",{"id":93,"doc_module":22,"doc_module_name":25,"category_name":94,"show_sort_weight":95,"slug":96},14,"Invoices",70,"invoices",{"id":98,"doc_module":22,"doc_module_name":25,"category_name":99,"show_sort_weight":100,"slug":101},15,"Posters",60,"posters",{"id":103,"doc_module":22,"doc_module_name":25,"category_name":104,"show_sort_weight":105,"slug":106},16,"Social Media",50,"social-media",{"id":108,"doc_module":22,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},17,"Forms",40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":82,"data":127},{"doc_id":79,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":85,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":108,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":140},1099523885336,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","# Texas MCO Prior\n\nAuthorizations  \n## What Texas providers need to know\n\nKELLY ROBERTS-TRETA  \nVP, Reimbursement & Ancillary Services  \nCreative Solutions in Healthcare  \nJASON JONES  \nChief Technology Officer  \nSimpleLTC  \nSept. 1, 2015  \n##  What we’ll cover today\n\n1. Review the new Standard Prior Auth Form  \n2. Review MMP Prior Auth process  \n3. Using the MCO Prior Auth Crosswalk to  \n2  \nstreamline information  \n4. Review the MMP Service Plan codesonMESAV  \n5. Creating Prior Auth forms in SimpleCFS™  \n## PRIOR AUTH PROCESSES\n\n##  Texas Standard Prior Authorization Form\n\n• Beginning Sept. 1, 2015, health benefit plan issuersmust accept the Texas Standard Prior AuthorizationRequest Form for Health Care Services if the planrequires prior authorization of a healthcare  \nservice  \n• Created by Texas Department of Insurance (TDI) to  \nstandardize prior auth requests across multipleMCOs  \n##  MMP Prior Authorization process\n\n• Reviewskilled nursing facility MMP quick referencedocument (page 4)  \n• Review prior authorization request form  \n• Review prior authorization criteria for Part A/SNFadmissions  \nSNF MMPquickreferencedocument(pg. 4)  \n##  MCO Prior Auth Crosswalk\n\n• We’ll review the items on the Prior Auth form andcompare to the crosswalk for easy reference  \n• Items required:  \n– DX code  \n– Treatment CPT code  \n– Frequency  \n– Duration  \n– \\# of visits requested  \n– Start and end dates  \nMCO Prior Auth Crosswalk  \nSimpleLTC will provide a downloadable version of thiscrosswalk at simpleltc.com/prior-auth  \n9  \n##  MMP Service Plan codeson MESAV\n\nEach MCO hasa differentplan code  \n\n| 4F   | Amerigroup Texas, Inc.   | Bexar   |\n| --- | --- | --- |\n| 3G   | Amerigroup Texas, Inc.   | El Paso   |\n| 7Z   | Amerigroup Texas, Inc.   | Harris   |\n| 6F   | Amerigroup Texas, Inc.   | Tarrant   |\n| 4G   | Molina Healthcare of Texas   | Bexar   |\n| 9J   | Molina Healthcare of Texas   | Dallas   |\n| 3H   | Molina Healthcare of Texas   | El Paso   |\n| 7V   | Molina Healthcare of Texas   | Harris   |\n| H9   | Molina Healthcare of Texas   | Hidalgo   |\n| 4H   | Superior Health Plan   | Bexar   |\n| 9K   | Superior Health Plan   | Dallas   |\n| HA   | Superior Health Plan   | Hidalgo   |\n| 7Q   | United Healthcare Texas   | Harris   |\n| H8   | HealthSpring   | \u003Cbr>\u003Cbr>Hidalgo   |\n| 6G   | HealthSpring   | Tarrant   |","cbCaiqlvBiI60ttZ","https://ap.wps.com/l/cbCaiqlvBiI60ttZ","pdf",1109169,"English","# What Texas providers need to know\n## What we’ll cover today\n## PRIOR AUTH PROCESSES\n## Texas Standard Prior Authorization Form\n## MMP Prior Authorization process\n## MCO Prior Auth Crosswalk\n## MMP Service Plan codes on MESAV","[{\"question\":\"What is the Texas Standard Prior Authorization Request Form used for?\",\"answer\":\"Health benefit plan issuers must accept the Texas Standard Prior Authorization Request Form when prior authorization is required for a health care service starting Sept. 1, 2015.\"},{\"question\":\"Which information items are required on the prior authorization form for the MCO crosswalk?\",\"answer\":\"The required items include DX code, treatment CPT code, frequency, duration, number of visits requested, and start and end dates.\"},{\"question\":\"How does the MMP prior authorization process work at a high level?\",\"answer\":\"It involves reviewing the MMP skilled nursing facility quick reference document, reviewing the prior authorization request form, and reviewing prior authorization criteria for Part A/SNF admissions.\"}]","Texas MCO Prior Authorizations Webinar Slides - 2015 | PDF",1789622843,6]