Table of Contents

Introduction

1 TMHP and DSHS Contact Information

2 Provider Enrollment and Responsibilities

3 Client Benefits and Eligibility

4 Authorizations and Prior Authorizations

5 Claims Filing, Third-Party Resources, and Reimbursement

6 Remittance and Status (R&S) Reports

7 Appeals and Administrative Review

8 Advanced Practice Nurse (APN)

9 Ambulance

10 Augmentative Communication Devices (ACDs)

11 Blood Pressure Devices and Supplies

12 Certified Registered Nurse Anesthetist (CRNA)

13 Certified Respiratory Care Practitioner (CRCP)

14 Dental

15 Diabetic Equipment and Supplies

16 Diagnostic Radiology Services

17 Durable Medical Equipment (DME)

18 Expendable Medical Supplies

19 Hearing Services

20 Home Health (Skilled Nursing) Care

21 Hospice

22 Hospital

23 Laboratory Services

24 Medical Nutrition Services

25 Neurostimulator Devices and Supplies

26 Orthotic and Prosthetic Devices

27 Outpatient Behavioral Health

28 Physical Medicine and Rehabilitation

29 Physician

30 Radiation Therapy Services

31 Renal Dialysis

32 Respiratory Equipment and Supplies

33 Speech-Language Pathology (SLP) Services

34 Transportation of Deceased Clients

35 Vision Related Services

36 TMHP Electronic Data Interchange (EDI)

A Acronyms and Initialisms Dictionary

B Forms