Billing Information

There are no copayments due for Aetna Better Health of Texas Medicaid Members for covered services.

Unless as specifically indicated in the Medicaid benefit descriptions, a provider can not bill or require payment from members for Medicaid-covered services. Providers can not bill, or take recourse against members for denied or reduced claims for services that are within the amount, duration and scope of benefits of the STAR Program.

There are no copayments due for Aetna Better Health of Texas CHIP Perinate or CHIP Perinate Newborn members for covered services.

Except as specifically indicated in the CHIP benefit descriptions, a provider can not bill or require payment, other than copay, from members for CHIP-covered services. Providers can not bill, or take recourse against members for denied or reduced claims for services that are within the amount, duration and scope of benefits of Texas CHIP. Aetna Better Health of Texas CHIP providers are responsible for collecting at the time of service any applicable CHIP copayments in accordance with CHIP cost-sharing limitations.

Copayments are the only amounts that Aetna Better Health of Texas CHIP providers can collect from CHIP members, except for costs associated with unauthorized non-emergency services provided to a member by out-of-network providers for non-covered services.

It may take several weeks to process a newborn’s member ID card once the newborn is enrolled. In the interim, use the mother’s ID card when administering care to the newborn. If after 31 days the newborn still has not received an ID card, contact Aetna Better Health of Texas Medicaid STAR Member Services at 1-800-248-7767 (Bexar) or 1-800-306-8612 (Tarrant).

 

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Aetna Better Health of Texas providers have 95 days from the date of service or within 95 days of the primary carrier’s Explanation of Benefits (EOB) for Coordination of Benefits (COB).

If an Aetna Better Health of Texas Medicaid or CHIP member decides to go to a provider that is not within our Medicaid or CHIP network or chooses to get services that have not been authorized or are not a covered benefit, the member must document his or her choice by signing the Private Pay Agreement and the Member Acknowledgement form.