CSCA with Austin Regional Clinic (ARC), Premier Family Physicians (PFP), and Capital Medical Clinic (Capital Medical) has been on a population health journey over the past few years and this program has been built off our experience and success as we transition, as many practices must, to value-based care. Working in partnership with locally operated Medicare Advantage plans, the program launched on January 1, 2019, enrolling Medicare Advantage (MA) members that are cared for by an ARC, PFP, or Capital Medical primary care physician.
Certain clinical and administrative services historically administered by the health plan will be provided by the CSCA team, including network, claims, UM/PHM/Authorizations.
For the plans below, please note the following –
For Aetna and Humana provider network needs, please click here for Humana, or call 1-800-448-6262 , and click here for Aetna or call 1-800-624-0756. Please note that, for 2019, your CSCA contract does not make you par with Aetna or Humana. Your existing network agreement with these Health Plans will continue to govern your reimbursement and contract needs.
- Humana Gold Plus HMO
- HumanaChoice PPO
- Aetna Medicare Premier Plan (HMO)
- Aetna Medicare Plus Plan (PPO – Travis and Williamson only)
- Aetna Medicare Choice Plan (PPO)
On September 1, 2019, CSCA will begin providing UM services for Humana Gold Plus HMO members. CSCA may also begin providing some UM activities for Aetna members in the fall as well. Please contact your CSCA customer service team at 737-236-0999 for additional information.