TMPPM 2010 > Volume 1, General Information > TMHP Telephone and Address Guide > Other TMHP Information > TMHP Electronic Data Interchange (EDI) Help Desk

Other TMHP Information

TMHP Contact Center

The TMHP Contact Center is available from 7 a.m. to 7 p.m., Central Time, Monday through Friday.

The TMHP Contact Center assists with questions such as:

•Provider enrollment procedures

•Claims filing procedures

•Policy information

The TMHP Contact Center is available to assist providers and clients. Please review the telephone and fax communication guides in this section for a list of contact phone and fax numbers.

For questions or information about Medicaid eligibility, clients are referred to their caseworker or the local Health and Human Services Commission (HHSC) office.

Automated Inquiry System (AIS)

AIS provides the following information and services through the use of a touch-tone telephone: claim status, patient eligibility, benefit limitations, Medically Needy case status, Family Planning, current weekly payment amount, and claim appeals.

Eligibility and claim status information is available on AIS 23 hours a day, 7 days a week, with scheduled down time between 3 a.m. and 4 a.m., Central Time. All other AIS information is available from 7 a.m. until 7 p.m., Central Time, Monday through Friday. AIS offers 15 transactions per call.

For full instructions on the use and benefits of AIS, refer to the "Automated Inquiry System (AIS) User's Guide" available on www.tmhp.com or call the TMHP Contact Center at 1-800-925-9126 for faxed instructions.

TMHP Provider Relations

The TMHP Provider Relations Department comprises a staff of Austin- and field-based provider relations representatives whose goal is to serve the health-care community by furnishing a variety of services and activities designed to inform and educate health-care providers about Texas Medicaid activities and claim submission procedures.

Provider Relations activities include the following:

•Provider education through planned events. Provider Relations representatives conduct a planned program of educational workshops, in-services, webinars, computer-based training (CBT) and other training sessions designed to keep all actively-enrolled providers informed of the latest policies, claim processing procedures, and federal and state regulations affecting Texas Medicaid.

•Problem identification and resolution. A staff of research coordinators is available to assist providers with clarification of Medicaid policies and assist with in-depth problem claim submission issues after initial inquiries are made with the TMHP Contact Center. Coordinators work closely with field-based regional representatives to coordinate the educational needs of the community.

•Relationship with professional health-care organizations. To ensure that Texas associations that represent health-care professions have up-to-date information about the requirements for participation in Texas Medicaid, the Provider Relations Department maintains a work relationship with these organizations. Also, the Provider Relations Department participates in several events sponsored by Texas health-care associations, such as conventions and conferences.

Visit www.tmhp.com for Provider Relations contact information, or call the TMHP Contact Center at 1-800-925-9126 for assistance.

TMHP Electronic Data Interchange (EDI) Help Desk

The TMHP EDI Help Desk assists Medicaid providers with EDI transactions. The TMHP EDI Help Desk is available at 1-888-863-3638 from 7 a.m. to 7 p.m., Central Time, Monday through Friday.

TMHP EDI Help Desk activities and responsibilities include, but are not limited to, the following:

•Enrolling providers for electronic billing

•Qualifying vendors for TMHP EDI production through testing

•Diagnosing claim transmission problems through research

•Consulting with provider billing personnel, billing services, and software vendors regarding TMHP EDI

TMHP EDI Help Desk staff assists with questions about TMHP EDI, TexMedConnect, and electronic transmissions at 1-888-863-3638.

Providers who employ hardware or software vendors should contact those vendors for the resolution of technical problems.