- Medicaid Plan Information
- Forms Library
- Claims Information
- Outpatient Auth Info
- HIPAA 5010 and ICD10
- Facility Info
- ELECTRONIC SOLUTIONS
- MHNet Provider Portal
- EDI Documentation
- User Support & Training
- NETWORK PARTICIPATION
- Provider Nomination
- Clinical Resource Info
- SPECIALIZED PROVIDER
- Autism Services
- Employer Services
- Psychological/Neuro-Psych Testing
At MHNet, we value the providers who take care of our members. Our website offers you all the tools you need and a free Provider Portal to assist with all of your practice needs online, anytime. Below is an overview, so you can find what you are looking for quickly. Simply select the title to go to the selected page or choose the area you want from the list on the left side of this page.
HealthCare USA Members
Effective Monday, February 9, 2015, ALL preauthorization requests for all levels of care will be managed by HealthCare USA as part of the integration efforts. For more details, click here to read the provider notification, including the assigned UM staff for each listed facility. Our portal at MHNetProvider.com will NO longer accept authorization requests.
HealthCare USA Member Prior Authorization/Case Management Contacts
- Prior Authorization/Outpatient Services
- Telephone: 1.800.882.9666
- Fax: 1.866.341.1327
- Intensive Outpatient Services: Contact Desley Wells 1.314.655.7619
- Inpatient and Partial Hospitalization Services: See list of Utilization Management assignments or Call 1.800.882.9666 and ask to speak to the UM staff person for your facility
- Case Management Services: Call HCUSA at 1.800.882.9666 And ask to speak with a Case Manager
Outpatient Authorizations Submission Changes
All outpatient authorization requests (OTRs) are submitted electronically through our provider portal at MHNetProvider.com except for HealthCare USA Medicaid members in Missouri (see information above). If you are not already taking advantage of the free portal for all your benefits, eligibility, and claims reviews, register now by clicking on www.MHNetProvider.com!
Once you are in the portal, click here for detailed instructions on submitting the authorization request. This Frequently Asked Questions document will also be helpful.
IF YOU ARE ALREADY REGISTERED FOR THE PORTAL, YOU MUST SUBMIT YOUR AUTHORIZATION REQUEST VIA THE PORTAL!
If you don't have internet capability, faxed OTR submissions should be sent to our new fax number 1.512.340.4213.
Click below for QUICK LINKS to frequently needed information
- Provider Nomination section explains joining the provider network
- Outpatient Authorization information, including what services NO LONGER require authorization!
- Provider Information Change Request for all address, TIN, name changes
- Provider Manual for the Provider/Facility Quick Reference Guides, including state-specific guides
- Claims Information about MHNet's Emdeon Payer ID 74289 (not the same as Coventry!)
- Summary of Changes to the most commonly used CPT codes
- Provider Nomination: Due to Aetna’s acquisition of MHNet/Coventry, we are in the process of consolidating our contracting and credentialing processes. MHNet no longer sends out or accepts MHNet credentialing applications. Please use Aetna’s online application process at www.aetna.com (select "Health Care Professionals", then "Join the Network", then "Behavioral Health Providers") to fill out and submit an Application Request Form to join Aetna’s provider panel.
- Clinical Resource Information: many resources to review, including our Provider Manual, Medical Necessity Criteria, Clinical Practice Guidelines, Newsletters, etc.
- Announcements/Alerts: the latest provider notifications, Provider Manual and Provider/Facility Newsletters
- Forms Library: all the forms you need, including the Provider Information Change Request
- Claims Information: all the claims information you need for electronic or paper submission, timely filing requirements, our Provider Portal to check claims status, EFTs and ERAs, etc.
- HIPAA 5010 and ICD10: information on our compliance with these regulations
- Facility Information: the Inpatient Authorization process and forms, ambulatory follow-up resources and appeals
- MHNet Provider Portal: information about the free, secure, online portal that allows providers to easily access information regarding member eligibility, authorizations, claims, and remittance advices
- EDI Documentation: our electronic solutions, including electronic claims submission, EFTs, ERAs and the Provider Portal
- Autism Services: Autism Guide with authorization information, Autism OTR
- Employer Services: contact information, and the EAP Case Record and instructions
- Psychological/Neuropsychological Testing: authorization information and the specific testing request forms
- PCPs: helpful resources for Behavioral Health