Wellpoint Texas credentialing for behavioral health (formerly Amerigroup)

Part of our credentialing guide for Texas practices and programs. Other Texas plans: Superior HealthPlan · every Texas Medicaid plan.

Wellpoint at a glance

Question	Answer
Who it is	An Elevance Health plan; Wellpoint is the name Amerigroup's Texas Medicaid plans now carry. It serves STAR, STAR+PLUS, STAR Kids and CHIP members in the service areas HHSC awarded it.
Before anything	TMHP enrollment in PEMS, and a complete, attested CAQH ProView profile.
New to Wellpoint	The Request for Credentialing / Letter of Interest form plus a W-9, emailed to [email protected].
Joining a contracted group	Wellpoint's online provider enrollment application on Availity Essentials; it reads your CAQH ProView data.
Rural (MRSA) members	Wellpoint uses MultiPlan's Texas True Choice network there; you join through MultiPlan.
Verification	The Texas Medicaid CVO (Wellpoint's page names Aperture, now part of Verisys) does primary-source verification.

Which Wellpoint company you contract with

Wellpoint runs Texas Medicaid through two companies, and the one on your contract depends on the members you'll serve. Per Wellpoint's Texas "join our network" page, Wellpoint Insurance Company serves members in the Medicaid Rural Service Area and the STAR Kids program, and Wellpoint Texas, Inc. serves all other Wellpoint members in Texas.

Why it matters: when you list products in your request, name both STAR Kids and the adult programs if you want them, and check that the contract you're sent covers the company and programs you asked for. A clinician credentialed for one isn't automatically paid for the other's members.

Where Wellpoint serves

On HHSC's managed care service areas map, when we checked, Wellpoint appeared for STAR in the Bexar, Harris and Lubbock service areas and for CHIP in Bexar and Harris. Wellpoint's own STAR+PLUS training names Jefferson among its STAR+PLUS service areas (Wellpoint STAR+PLUS overview). Plan line-ups change with HHSC's contracts, so open the map for each county you serve. If Wellpoint doesn't serve your area, skip it: the effort is better spent on the plans that do (our Texas Medicaid plans by area page helps you choose).

Pick your route

You are	Route	What you send
A clinician or group new to Wellpoint	Letter of interest	Request for Credentialing / Letter of Interest form and a W-9 to [email protected]
A clinician joining a group that already contracts with Wellpoint	Availity Essentials	The online provider enrollment application; CAQH data is pulled in
A provider serving rural (MRSA) members	MultiPlan Texas True Choice	MultiPlan's network application (contact MultiPlan through the number on Wellpoint's page)
An IOP or PHP program	Letter of interest, as a facility	The form and W-9, then the facility application Wellpoint sends back

Route 1: the letter of interest

Wellpoint's Texas page asks new providers to complete the Request for Credentialing / Letter of Interest form and return it, with a W-9, to [email protected]. Your information then goes to the Texas CVO for verification.

1. Fill the form for the entity that will bill: the legal name and Tax ID on the IRS letter, the NPI (Type 2 for a group or program), the service address and your TMHP Texas Provider Identifier.
2. List every clinician who will see Wellpoint members, with license numbers and individual NPIs, and confirm each has an attested CAQH profile with Wellpoint authorized.
3. Name the programs you want (STAR, STAR+PLUS, STAR Kids, CHIP) and your service area.
4. Sign and date the W-9 with the IRS-registered legal name, not a DBA.
5. Email it and log the date. Ask for written confirmation that it was received and who your network contact is.

Route 2: Availity for group additions

If you're adding a clinician to a group that already has a Wellpoint contract, or you're filling a contracted role, Wellpoint routes you to its online provider enrollment application on Availity Essentials. Wellpoint's Texas network FAQ says the system automatically pulls the information already in your CAQH ProView profile, so update and re-attest CAQH before you start; stale CAQH data flows straight into the application.

Group additions may also qualify for Texas Medicaid's expedited credentialing. State law requires every Medicaid plan to let certain providers who join an established, contracted group, and who are enrolled in Texas Medicaid, provide services provisionally while credentialing finishes (Texas Government Code §540.0656; 1 TAC §353.423). LCSWs, LPCs, LMFTs and psychologists are among the provider types Texas plans list for it. Ask Wellpoint to process the addition as expedited and get the provisional start in writing.

Route 3: the rural service area

For the Medicaid Rural Service Area (MRSA), Wellpoint says it contracts with MultiPlan's Texas True Choice network rather than building its own. If your clients live in rural counties Wellpoint serves, join Texas True Choice through MultiPlan; Wellpoint's Texas page gives the number to call. Check which network your contract is under before you bill a rural member.

Verification and status

Wellpoint's page says your information goes to the Texas Credentialing Verification Organization, which performs all application verifications, including primary-source verification, and names Aperture. Aperture is now part of Verisys, which TAHP describes as the current Texas Medicaid CVO (TAHP presentation to HHSC's managed care advisory committee, 2024). Every Texas Medicaid plan must use it, member of TAHP or not, so documents verified for one plan are shared with the others; Wellpoint's own committee and contract still come after.

Status questions about verification go to the CVO (Wellpoint's page lists its number); questions about the contract go to Wellpoint's network team. Keep both in your log, with the date of each call and what you were told.

For IOP and PHP programs

A Texas SUD program contracts as a facility: HHSC license first, then TMHP enrollment as a chemical dependency treatment facility, then the plans. In the letter of interest, ask for the facility credentialing application and say which levels of care you offer. Expect to send the license, accreditation letter if you have one, liability certificates, the ownership disclosure, policies and a roster, and ask whether Wellpoint does a site visit. Our guide to insurance contracts for treatment centers lists the packet and the contract terms to check.

Ask three questions before you sign:

• Does Wellpoint offer adult PHP and IOP as in-lieu-of services in your area, and with what prior authorization rules? HHSC lets plans offer them in place of inpatient care; see our Texas Medicaid IOP and PHP guide.
• How will program days be paid: per diem by HCPCS code (H0015, S9480, S0201, H0035) with a revenue code, or per service? HHSC has asked plans to track PHP and IOP by HCPCS code.
• Does Wellpoint also credential your clinicians individually, and does anyone outside Wellpoint handle behavioral health authorizations for your members? We couldn't confirm the answer from Wellpoint's public Texas pages, so get it from your network contact and the Wellpoint Texas Medicaid provider manual.

The IOP / PHP Program Launch carries the license, TMHP and every facility contract on one dated roadmap.

After you're in

• Get the effective date in writing for each program and company, and load it in your EHR before the first claim.
• Register for Availity Essentials, where Wellpoint hosts its online provider applications, and ask your network contact which tools (eligibility, authorizations, claims, remittances) you'll use there.
• Check eligibility before every admission and each month. Medicaid members can switch plans; our sister site's prior authorization guide covers keeping authorizations current.
• Re-attest CAQH every 120 days so recredentialing has current documents.

Why Wellpoint files stall

• No TMHP enrollment yet, or an LPC or LMFT without Medicare enrollment (Texas has required it since March 1, 2024).
• CAQH incomplete or not attested, so the Availity application pulls old data.
• The letter of interest sent without a W-9, or a W-9 with a DBA instead of the legal name.
• Asking for the wrong company or program, so the contract doesn't cover STAR Kids or rural members.
• A program applying before its HHSC license issues.
• Seeing members before the effective date without an expedited, provisional approval in writing.

How we work a Wellpoint file

Our credentialing service picks the right route, builds or fixes CAQH, sends the letter of interest or the Availity application, follows up every two weeks with Wellpoint and the CVO, reviews the contract, and confirms the effective date in writing. Wellpoint as an additional Medicaid plan for a clinician is $175 per plan; a program's facility contract is $450 per plan; Texas Medicaid enrollment with a first plan is $350 per clinician. For example, a group adding two clinicians to Wellpoint and Superior: $700.

Plans	Typical time	Reads CAQH
Commercial plans Aetna, Cigna / Evernorth Behavioral Health, UnitedHealthcare / Optum Behavioral Health, Blue Cross and Blue Shield of Texas	45–120 days	Yes
Medicare (PECOS)	30–90 days	No
Medicare Advantage plans Humana (Medicare Advantage), Medicare Advantage plans	60–120 days	Yes
Texas Medicaid (TMHP)	30–60 days	No
Texas Medicaid and CHIP managed care plans Superior HealthPlan, Wellpoint Texas (formerly Amerigroup), Molina Healthcare of Texas, Community Health Choice and 9 more	60–120 days	Yes
Marketplace plans Ambetter (marketplace), Oscar Health (marketplace)	60–120 days	Yes
Behavioral health managers Magellan Healthcare, Carelon Behavioral Health (formerly Beacon Health Options)	60–120 days	Yes
Employee assistance and benefit networks ComPsych (EAP), Lyra Health, Spring Health	30–90 days	No
TRICARE and VA Community Care TRICARE, VA Community Care Network	60–120 days	No

Questions

Is Wellpoint the same as Amerigroup in Texas?

Yes. Amerigroup's Texas Medicaid and CHIP plans now carry the Wellpoint name. Older documents and some links still say Amerigroup.

How do I join Wellpoint's Texas Medicaid network?

Enroll with TMHP, finish CAQH, then email Wellpoint's Request for Credentialing / Letter of Interest form with a W-9 to [email protected]. If you're joining a group Wellpoint already contracts with, use the online application on Availity Essentials instead.

Does Wellpoint use CAQH?

Yes. Wellpoint's Texas network FAQ says the Availity enrollment application pulls the information in your CAQH ProView profile, so keep it complete and attested.

Who verifies my credentials for Wellpoint?

The Texas Medicaid credentialing verification organization that every Texas Medicaid plan uses. Wellpoint's page names Aperture, now part of Verisys.

How do I get in network for rural Texas Wellpoint members?

Wellpoint uses MultiPlan's Texas True Choice network for the Medicaid Rural Service Area. Join that network through MultiPlan.

How long does Wellpoint credentialing take?

Wellpoint doesn't publish a Texas timeline we could verify. We budget about 90 days for a Texas Medicaid plan once TMHP and CAQH are done; follow up every two weeks.

More Texas plan guides: Superior HealthPlan · Texas Medicaid plans by area · Texas Medicaid for IOP and PHP · TMHP enrollment · CAQH ProView guide

Sources

All checked October 24, 2026. Plans revise these pages and forms; open the current version before you rely on any detail.

1. Wellpoint, Texas provider "Join our network" (letter of interest, TXCredentialing mailbox, W-9, Texas CVO, Availity, MultiPlan Texas True Choice, the two Wellpoint companies). provider.wellpoint.com
2. Wellpoint, Texas network FAQ (Availity application pulls CAQH ProView data). provider.wellpoint.com
3. Wellpoint, STAR+PLUS overview for Texas providers (service areas). wellpoint.com
4. Wellpoint, Texas Medicaid provider manual. wellpoint.com
5. Texas HHSC, Managed Care Service Areas map. hhs.texas.gov
6. Texas Association of Health Plans, credentialing presentation to the State Medicaid Managed Care Advisory Committee, February 2024 (Verisys; CVO required for all Medicaid MCOs). tahp.org
7. Texas Government Code §540.0656, Expedited Credentialing Process for Certain Providers. law.justia.com
8. 1 Tex. Admin. Code §353.423, Expedited Credentialing. law.cornell.edu
9. Superior HealthPlan, "Behavioral Health PHP and IOP Billing Code Update," September 11, 2025 (HHSC asked MCOs to track PHP and IOP by HCPCS code). superiorhealthplan.com

This guide is general information. Cima Consulting isn't a law firm or an accounting firm. Wellpoint, HHSC and TMHP make their own decisions; we don't guarantee approvals, rates or dates. We aren't affiliated with Wellpoint or Elevance Health.