Tava Health supports a limited set of Utah Medicaid plans. This article explains which plans and providers are supported, how billing works, what documentation is required, and answers common questions.
Supported plans
The following Utah Medicaid plans are currently supported for billing on Tava Health:
- Utah Medicaid
- Select Health Community Care (Medicaid)
- University of Utah Health Plans Healthy U (Medicaid)
Health Choice (Medicaid) and Molina (Medicaid) are not supported. If your client's plan isn't one of the supported plans, they can not be billed on Tava Health. Other Medicaid plans, and other states, aren't supported at this time.
Enrollments and Eligibility
Providers must be independently enrolled with Utah Medicaid plans as an individual provider before they can be connected to Tava’s Medicaid billing entity. Tava does not complete the initial Medicaid enrollment.
- Provider enrolls with Utah Medicaid and is approved/credentialed on their own.
- Tava’s credentialing team links that existing enrollment to Tava’s billing entity automatically. Tava's credentialing team will reach out directly if any additional information is needed to complete your enrollments.
- Enrollments will move from submitted to pending to enrolled, and can take up to 90 days to complete. Providers can track their status for all insurance plans, here.
- Providers will be alerted by email when their Utah Medicaid enrollment is complete. At this point, providers can bill Utah Medicaid plans through Tava Health.
All eligible Tava Health providers are automatically enrolled. For providers not yet enrolled with Medicaid and would like to be, you can begin the process here. Once enrolled, reach out to credentialing@tavahealth.com with your Medicaid ID to let us know.
Documentation and requirements
Medicaid plans can be audited more closely than commercial plans, so keeping a complete clinical record is important. Requirements can differ by plan, and this article covers only the supported plans above.
Session Notes
Tava Health will automatically apply essential client and provider identification information, service details, and signatures. Providers should include two additional elements when drafting their written notes:
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Medical Necessity and Clinical Rationale:
- A clear explanation of why the service was needed today, tied directly to the client's diagnosis, symptoms, and functional status.
- Reference to an active, approved treatment plan, individualized education program (IEP), or plan of care (POC).
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Interventions, Progress, and Plan:
- A summary of the specific interventions or therapies provided.
- The patient's response or progress (or lack thereof) toward established, measurable goals.
- The plan for ongoing treatment or the next session
For a step-by-step guide to session notes, see here.
Treatment Plans
Treatment plans are not submitted with session notes, and should instead be maintained independently. This can be through a separate EHR, or stored as a document uploaded to the client profile on Tava Health.
Providers can download a sample treatment plan template, here.
Identifying clients with a Medicaid plan.
Both Tava Referral clients and self-referral clients may use a Medicaid plan. If Tava referred a client to you, they may have a supported Medicaid plan without you realizing it. Check the coverage shown on their profile, and look for these plan names: Utah Medicaid, Select Health Community Care, University of Utah Health Plans.
Medicaid clients need the documentation described above.
If a client's Medicaid plan isn't supported on Tava, independently enrolled providers may use Flexible Billing to bill these sessions separately.
Frequently asked questions
Which Medicaid plans does Tava Health work with?
Utah Medicaid, Select Health Community Care (Medicaid) and University of Utah Health Plans Healthy U (Medicaid). We can't work with Health Choice, Molina or any other Medicaid plans at this time.
Can I see clients with Medicaid in other states?
Not yet, but we are constantly working to add additional payers.
I was already enrolled with Medicaid. Do I need to enroll again?
Previously enrolled providers are now able to see Utah Medicaid clients through Tava Health!
How do I know I'm approved to bill Medicaid on Tava?
You can check your enrollment status here. Look for these three payer names: Utah Medicaid, Select Health Community Care (Medicaid) and University of Utah Health Plans Healthy U (Medicaid)
A client says they have Medicaid. How do I check that their plan is supported?
Look at the plan name on their coverage. If it matches one of the plans above, we can bill it. If not, we can't. Additionally, Tava Health verifies eligibility when saved to the client profile and before each claim is processed. For clients entering their own insurance information, they will be notified if their plan is not accepted.
Do I need a treatment plan?
Yes. Tava Health does not require one to submit your note, but a treatment plan must be kept on file. You can choose to keep it in your clinical record, or upload to the client profile.
Does Tava Health provide treatment plan templates?
Yes. You can download templates here.
What happens if my claim is denied?
Tava Health's clawback protection means you never have to pay for claim denials. Tava Health bears the cost.
How are Medicaid sessions paid out?
You can view your rates for each individual plan, here.
Does this change anything for my clients using commercial plans or an EAP benefit?
No. This applies only to clients with a supported Medicaid plan.