TMHP, Health and Human Services Commission (HHSC), State Medicaid Contractor has been working to process thousands of applications. As of last week, HHSC/TMHP reported that they are still hundreds of providers who have not re-enrolled. To verify your re-enrollment status, please go to the TMHP website at www.tmhp.com and log into My Account as a provider administrator, Select Provider Information Management System (PIMS), which is located under “Manage Provider Accounts.” The PIMS Administrator Screen will display two new columns: “Federal Re-enrollment Complete” and “Federal Re-enrollment Date.”
If you are unsure about your status or have any questions, please contact a TMHP representative for guidance. You can reach a TMHP provider enrollment representative by calling the TMHP Contact Center at 1-800-925-9126 (after dialing, select option 2 for “provider enrollment”), or the TMHP–CSHCN Services Program Contact Center at 1-800-568-2413. DADS providers and Medicaid MCO Long-Term Services and Support (LTSS) providers may also submit questions via DADS Provider Re-enrollment Mailbox: Texas.Medicaid.Enrollment@dads.state.tx.us.
All agencies that provide services in Medicaid must revalidate their enrollment. This means that all providers, including ordering and referring providers, who have not met all revalidation requirements must complete all processes of re-enrollment by September 24, 2016. If you submitted an application all discrepancies must be addressed within the required timeframe and must meet the deadlines indicated on deficiency letter(s). Any applications in pending process will be closed on September 25, 2016 and the organization will risk nonpayment on claims.
If you have NOT completed a re-enrollment application you must submit it now to ensure it is received on or before June 17, 2016. ALL TPIs and claims associated will be at risk for non renewal and/or nonpayment of claims beginning September 25, 2016.
Important to note: Once an application is received by TMHP a review is conducted. Should TMHP find a discrepancy or if they need additional information a letter will be sent to you with a 6 digit identifier number called a “Kintana number” requesting additional information. Any forms returned or requests for additional information must be corrected and responded to with 30 days of the date of the letter using the Kintana number in order for TMHP to identify and continue processing your application.
It is extremely important that all corrections or information requested be returned within 30 days of the date of the letter.
Please follow the procedures below when responding to letters/notices:
- If your application was submitted online through the TMHP Provider Enrollment on the Portal (PEP), you can submit updates through PEP by choosing "View Existing Transactions", selecting the portal ticket number of the application you wish to update, and clicking "Edit". After making the necessary revisions, submit the application by navigating to the "Final Acknowledgement" screen at the end of the application and click "I Accept".
- If you submitted a paper enrollment application, you must submit revisions, along with a copy of the notice or letter to: Texas Medicaid & Healthcare Partnership, Attn: Provider Enrollment Department, PO Box 200795, Austin, TX 78720-0795.
- Pages that do not require your signature can be faxed to 1-512-514-4214. If you have any questions, please call the TMHP Contact Center at 1-800-925-9126, and select Option 2.
Please click here for Texas Medicaid Provider Enrollment FAQs. Please click here for comprehensive information on all programs including Department of Aging and Disability Services (DADS), Managed Care Organizations (MCO) and Texas Medicaid Enrollment revalidation requirements.