Claims/Enrollment

Medicaid Provider Enrollment

The Texas Medicaid & Healthcare Partnership (TMHP) enrolls providers in the Texas Medicaid program and other state healthcare programs. TMHP has representatives throughout Texas to assist providers with education and training on the TMHP provider enrollment application process and requirements. TMHP offers assistance with completing and submitting the TMHP enrollment application.

For more information about enrollment in Texas Medicaid or other State Health-Care programs, visit the TMHP Provider Enrollment webpage.

Medicaid Provider Re-enrollment

Due to a new federal mandate, all Texas Medicaid providers must periodically revalidate their enrollment in Texas Medicaid.  Providers enrolled before January 1, 2013, must re-enroll by March 24, 2016.

For additional guidance please visit the TMHP Provider Re-enrollment page. For help re-enrolling, contact a TMHP provider enrollment representative at 1-800-925-9126, Option 2, or attend one of the town hall meetings.

 

Managed Care Contact Information

Medicaid providers, including pharmacies, who want to contract with a medical or dental managed care plan must contact the managed care organization (MCO) of their choice to complete a separate contract and credentialing application in addition to enrolling with TMHP. For MCO provider representative contact information, go to MCO Provider Representative Contacts.

Texas Medicaid and Healthcare Partnership (TMHP)

TMHP processes claims for Texas Medicaid and other state programs. As claims administrator, TMHP processes claims for Medicaid services provided in the traditional, fee-for-service system. TMHP does not process claims for services provided by Medicaid managed care organizations (MCOs), but does collect encounter data from MCOs for use in evaluation of quality and utilization of managed care services.

Resources

  • Contact Center General Inquiries Line: 1-800-925-9126
    This provider help line offers assistance and general information about policy education, claims filing assistance, financial inquiries, eligibility inquiry, Title XIX Family Planning, and provider education.
  • EDI Help Desk - Technical Support contact information: 1-888-863-3638
    Get assistance with TexMedConnect (TMC) access, password reset, and troubleshooting TMC and EDI technical issues.
  • Electronic Health Records and Information
    Learn about the Medicaid Electronic Health Record (EHR) Incentive Program, eligibility requirements, and the EHR Information Exchange System.