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Provider Manual Overview
The 2008 Texas Medicaid Provider Procedures Manual is divided into three parts, including:
Part I: Provider Information
The information in Part I is for all health-care providers who are enrolled in Texas Medicaid and provide services to Texas Medicaid clients. In Part I, providers find instructions for providing allowable services and receiving appropriate reimbursement for services. The following sections are included in Part I:
• Introduction
•TMHP Telephone and Address Guide
•Section 1. Provider Enrollment and Responsibilities
•Section 2. Texas Medicaid Reimbursement
•Section 3. TMHP Electronic Data Interchange (EDI)
•Section 4. Client Eligibility
•Section 5. Claims Filing
•Section 6. Appeals
•Section 7. Managed Care
Part II: Texas Medicaid Services
Part II contains a section for each Texas Medicaid service with information on health-care policy, procedures, and claims filing pertaining to each provider type.
Part III: Appendices
Part III contains the following appendices for quick reference to commonly used information:
•Appendix A. State and Federal Offices Communication Guide
•Appendix B. Forms
•Appendix C. THSteps Forms
•Appendix D. Claim Form Examples
•Appendix E. Vendor Drug Program
•Appendix F. Acronym Dictionary
•Appendix G. HIV/AIDS
•Appendix H. Immunizations
•Appendix I. Medical Transportation
•Appendix J. Lead Screening
•Appendix K. Texas Health Steps Statutory State Requirements
•Appendix L. Hearing Screening Information
•Appendix M. THSteps Quick Reference Guide
•Appendix N. THSteps Dental Guidelines
•Appendix O. Women's Health Program
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