Network Providers
This page serves as a resource for physicians and ancillary providers who work with HealthTexas Primary Care Doctors. Please be advised that this page intends to discourage or prohibit a participating provider from discussing with a member treatment options or providing other medical advice or treatment deemed appropriate by a participating provider.
HealthTexas upholds the following:
- Utilization Management (UM) decision making is based only on appropriateness of care and service and existence of coverage.
- HealthTexas does not specifically reward practitioners or other individuals for issuing denials of coverage.
- Financial incentives for UM decision makers to not encourage decisions that result in underutilization.
Referral Team:
Assist with Referral and prior authorization submission process, verifying member eligibility, helping you to obtain UM criteria, etc.
No Authorization Required List:
Claims Team:
| HealthTexas Electronic Payor ID | HTHTX |
| Claim Status, Confirmation of Receipt, and Payment Information | https://providerportal.healthtexas.org/EZ-NET60/Login.aspx
To set up portal access, please contact 210-334-3459 HealthTexas EZ-Net Provider Portal Terms of Use |
| ACH/EFT Enrollment email | PM_ElectronicFundsTransfer@healthtexas.org |
| Disputes and Reconsiderations | Disputes and Reconsiderations should be submitted to: P.O. BOX 100155, San Antonio, TX 78201 |
Credentialing Team:
Assist with any Credentialing issues and updates to demographic information and directory information.
Network Contract Team:
Available to assist with any contracting questions; responsibilities include educating and servicing physicians. For more information email our Provider Contracting Team at: ProviderContracting@healthtexas.org
Quick Reference Guide for Network Providers:
Specialist Survey:
Direct LINK for Specialists to UHC’s required SNP Model of Care training:
Contracted Providers are required to complete Annual Training, as a reminder, The Centers for Medicare & Medicaid Services (CMS) requires Medicare Advantage (MA) organizations and Part D plan sponsors, including UnitedHealthcare and their delegates, i.e. HealthTexas Medical Group of San Antonio, to annually communicate specific Compliance and FWA requirements to their “first tier, downstream and related entities” (FDRs). FDRs include contracted physicians, health care professionals, facilities and ancillary providers as well as delegates, contractors and related parties.
As a delegate of UnitedHealthcare, HealthTexas Medical Group of San Antonio adheres to general compliance training and Fraud, Waste, and Abuse resources are available at unitedhealthgroup.com, this will also include Special Needs Plan Model of Care Training, this is required for :
Direct LINK for Specialists to UHC’s required SNP Model of Care training:
Credentialing:
Contracted Providers joining or departing your organization:
- For any new providers joining or departing your organization, please send all notifications to our Credentialing Department’s email address.
- Credentialing@healthtexas.org
