Overview
The
Texas Department
of State Health Services
(DSHS) and the Texas Health and Human Services Commission (HHSC) oversee services provided for family planning preventive health, medical services, counseling services, and educational services. The main objective for the Family Planning program is to provide an avenue, to qualified individuals, for achieving optimal reproductive and general health. The Texas Medicaid & Healthcare Partnership (TMHP) processes Family Planning claims and encounters for four different funding sources. The funding sources are categorized as Program 100 (Title XIX, Medicaid), Program 200 (Title XIX, Medicaid Managed Care), and Program 300 (Titles V, X, and XX). To learn more about the DSHS Family Planning Division (FPD), please visit the DSHS FPD website. For more information about becoming a Medicaid Family Planning provider, please refer to the TMHP Provider Enrollment page.
Hot Tips
- Did you know that one of the top five reasons sterilization claims are denied is due to not having a valid sterilization consent form on file? Please submit the sterilization consent form at least 24 hours prior to submitting the sterilization claim.
- You can reduce the number of denied sterilization claims by validating that the recipient's name and date of birth on the consent form are identical to those on the sterilization claim. If the recipient's name and date of birth do not match letter for letter/number for number, those claims will suspend and potentially deny.
- You can reduce the number of denied or rejected sterilization claims by assuring the writing on the sterilization consent form is legible.
- All DSHS Family Planning contractors MUST use the 2017 claim form for billing Family Planning services.
- Medicaid-only Providers who do NOT contract with DSHS may use either the 2017 or HCFA 1500 when billing for family planning services. If submitting claims through a Medicaid HMO, please see the Managed Care section of Section 20 – 2009 Texas Medicaid Provider Procedures Manual .
Family Planning Resources on the TMHP website
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Family Planning Forms
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Family Planning Contact Information
- DSHS Family Planning
Preventive and Primary Care Unit:
1-512-458-7796
- TMHP Family Planning Customer Service line: 1-800-925-9126 (choose option 4 for Family Planning)
- TMHP Family Planning Sterilization Form Fax line: 1-512-514-4229
- Automated Inquiry System (AIS) line: 1-800-925-9126
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Family Planning Helpful Links
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