As the third party administrator, Aetna will provide PCHP with administrative services which include member services, claims processing, medical management, accounting services, quality management, information systems support, provider relations and community outreach teams.
"Continuing our partnership with Parkland Community Health Plan not only reinforces the positive relationship that we have established over the last 10 years, but also allows us to further cultivate and expand the processes that we have jointly developed to manage the health needs of the Medicaid and CHIP population in the Dallas service area," said Nadine Hauf, executive director of Aetna Medicaid and CHIP services.
The Parkland Community Health Plan, Inc., an integral part of the Parkland Health and Hospital System, is a managed care organization that was created to serve as a bridge connecting the community's uninsured population to programs and services designed specifically for them, including Medicaid Managed Care and the CHIP programs. PCHP works with 1,900 health care providers and organizations, including 30 hospitals and medical centers.
In the past ten years of Aetna administering TPA services for PCHP, membership has grown from 500 members to nearly 145,000 members in the Medicaid and CHIP programs. To meet the growing membership numbers, Aetna has increased its service team from 20 employees to more than 200.
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 37.2 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. www.aetna.com