TMPPM 2010 > Volume 1, General Information > Section 8: Managed Care > PCCM > Primary Care Provider Selection and Changes > Changing a Primary Care Provider

   
 

8.6.8.2 Changing a Primary Care Provider

PCCM clients may change their primary care provider at any time, by calling the PCCM Client Helpline at 1-888-302-6688 or by submitting the Form 8.8, "Primary Care Case Management (PCCM)- Medicaid Primary Care Provider Selection Form" of this handbook and on the PCCM web page on the TMHP website at www.tmhp.com.

PCCM clients receive a primary care provider change notification letter after requesting a change to their primary care provider.

If a client request for a primary care provider change is successful, the notification letter will list the name of the new primary care provider and the effective date of the change. Clients will be instructed to take both the notification letter and their Medicaid Identification Form (Form H3087) to the new primary care provider's office.

Successful requests for primary care provider changes that are received through the last business day of the month usually become effective on the first day of the next month and are reflected on the following:

All eligibility verification systems

The claims payment system

The client's primary care provider change notification letter

Clients will also receive a notification letter if their primary care provider request is unsuccessful. If a change request is unsuccessful, the notification letter provides possible reasons that the request was not processed and a number for the client to call for assistance.

Refer to: Subsection 8.1.7.1, "Client-Initiated Primary Care Provider Changes" in this section for information about effective dates of primary care provider changes.


Texas Medicaid & Healthcare Partnership
CPT only copyright 2009 American Medical Association. All rights reserved.
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