2.1 Provider Enrollment

Providers must be actively enrolled as a Texas Medicaid provider as a prerequisite to enrolling as a CSHCN Services Program provider. For information about Texas Medicaid enrollment requirements, or to complete an online enrollment, visit the TMHP website at www.tmhp.com. Providers can call the TMHP Contact Center at 1-800-925-9126 for additional information.

Refer to:

Section 26.3, “Medical Foods,” on page 26‑8.

Chapter 37, “Transportation of Deceased Clients,” on page 37-1.

To enroll in the CSHCN Services Program, a provider must complete the required CSHCN Services Program Provider Enrollment Application and enter into a written Provider Agreement with the CSHCN Services Program. The physical address, National Provider Identifier (NPI), and Tax ID on the CSHCN Services Program application must correspond to the Medicaid provider enrollment. The taxonomy code can be different from the taxonomy code selected for the Medicaid enrollment. Forms are available for download from the TMHP website at www.tmhp.com.

Current Texas Medicaid providers that want to enroll with the CSHCN Services Program can use the CSHCN Services Program Expedited Enrollment Application found on the TMHP website at www.tmhp.com.

Providers that choose to complete the expedited enrollment application can also submit the following optional items if applicable:

•	Electronic Funds Transfer (EFT) Notification

•	Rehabilitation Engineering and Assistive Techonology Society of North American (RESNA) certification for custom DME enrollment

Providers may also enroll online by logging into Provider Enrollment on the Portal (PEP).

Online enrollment has the following advantages:

•	Updated on-screen instructions make the online application process more efficient and user-friendly.

•	Applications are validated immediately to ensure that all fields have been completed.

•	Most of the application can be completed online so that only a few forms need to be printed, completed, and mailed to TMHP. Forms that must be mailed are identified in the online application.

•	Applicants can view incomplete and complete applications that have been submitted online.

•	Some form fields are automatically completed, reducing the amount of information that has to be entered.

•	Providers can complete the Provider Information Change (PIC) Form online.

•	Providers will receive e-mail notifications when messages or deficiency notices about their applications are posted online. Providers may opt out of e-mail communication and receive messages or deficiency letters by mail.

•	Providers can create templates, which makes it easier to submit multiple enrollment applications.

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Providers enrolling as groups (either new groups or group providers adding an additional TPI suffix) can assign portions of the application to performing providers to complete. The performing provider assignment functionality will not exist if the group is already enrolled when attempting to add a performing provider to the group.

•	Performing providers can complete their portion of a group application by logging into Provider Enrollment on the Portal (PEP) with their unique user name and password.

•	Providers can navigate to completed sections of the application without having to click through all pages of the application.

•	Information that is on file for owners and subcontractors of the applying provider is auto-populated in the application.

•	Before submitting an application to TMHP for processing, providers are required to review a portable document format (PDF) copy of the application and verify it is complete.

•	Providers can edit submitted applications to correct identified deficiencies.

If not completed online, the enrollment application and other completed forms must be sent to TMHP Provider Enrollment at the following address:

Texas Medicaid & Healthcare Partnership
Attn: Provider Enrollment
PO Box 200795
Austin, TX 78720–0795
Fax: 1-512-514-4214

For assistance with the application process or to obtain enrollment forms, call the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413, which is available Monday through Friday, from 7 a.m. to 7 p.m., Central Time.

A CSHCN Services Program provider identifier is issued when all required forms and documentation have been received and the application process is completed. The provider identifier is a unique number assigned to each provider. A provider cannot be enrolled if his or her license is due to expire within 30 days of the date of application. TMHP verifies license information provided with the enrollment application.

The provider’s enrollment effective date will be 6 months before the date the enrollment application is received or the traditional Medicaid enrollment effective date, whichever is more current.