Redefine the Provider Experience
Therapy benefit management shouldn't be complex or frustrating. At Holista's Therapy Division, we simplify and elevate the way providers engage with healthcare administration.
As the trusted third-party administrator for the CVS/Aetna program in Colorado, Oklahoma, and Texas, we provide streamlined systems, responsive support, and tech-driven solutions. Our approach improves payment accuracy and reduces administrative burden so providers can focus on what matters most: quality care.
Before submitting claims, providers must obtain an authorization from Holista through our Provider Web Portal (PWP). While the term “authorization” can be confusing, it’s not a pre-authorization and has no impact on the member’s benefits. It’s simply an internal 60-day tracking number we use to link claims and payments in our system—ensuring everything is properly routed, reviewed, and reimbursed.
To avoid delays and ensure in-network treatment, all claims should be submitted directly to Holista—not the insurance company. Since you're contracted with Holista and we’re contracted with the insurance company, we serve as the bridge between both parties. We accept claims through several convenient submission methods, making it easy to integrate with your existing billing systems.
Our dedicated AR team carefully reviews submitted claims to ensure they’re accurate, processed correctly, and in-network in accordance with the member’s benefits. We work closely with providers to resolve any issues quickly and handle each claim with precision and care. On behalf of the member, we’ll call, email, and fax all necessary information—so when you receive a final determination, you can trust it’s the correct one, without the headache of chasing down the insurance company to have claims reprocessed.
If a claim is placed on hold or "pended," our Medical Records team may reach out for additional information—such as Coordination of Benefits (COB) updates, supporting documentation, or primary Explanation of Benefits (EOBs) when other insurance coverage is involved. This ensures claims are fully documented and compliant for processing.
Once your claims are approved, Holista processes payment efficiently. Through our Provider Web Portal, you can view any applicable case fee payments and patient liability amounts. Our goal is to make it easy to track and reconcile payments without administrative hassle.
Our current portal allows you to easily submit and manage claims and authorizations. And coming in late 2025 or early 2026, we’re launching an enhanced Provider Web Portal with new features—including patient eligibility verification and expanded self-service tools. It’s all part of our commitment to delivering a streamlined, provider-friendly experience.
As a third-party administrator, Holista serves as a bridge between you (or your office) and the member’s insurance company. It’s important to note that we do not make decisions regarding a member’s plan, benefits, or visit limits. All benefit determinations are made by the insurance company based on the member’s specific plan. Our role is to support and streamline the process—not to define the rules.
Ready to join our network?
We are currently accepting applications for the Aetna network in Colorado, Oklahoma, and Texas!
Fill out a network application by clicking the link below.
Network Application Form