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7.5.9 Support Services
7.5.9.1 Provider Support Services
PCCM core support services to primary care providers include:
• Provider Helpline. The PCCM Provider Helpline at 1-888-834-7226 is available to assist PCCM providers with a broad range of Medicaid and PCCM issues. Toll-free customer service lines are available Monday through Friday, from 7 a.m. to 7 p.m., Central Time, and are answered directly by call center representatives.
•Provider Relations Representatives. Provider relations representatives conduct informational and educational workshops, group meetings, and training sessions for office practices and groups when requested, and can assist in enrolling new primary care providers in PCCM. To contact the provider relations representative serving your area, call the TMHP Contact Center at 1-800-925-9126 or visit the TMHP website at www.tmhp.com.
•Medical Director Services. The TMHP Medical Director maintains overall responsibility for utilization management procedures, quality improvement activities and reporting, health education for both clients and providers, authorization requirements, and claim appeals related to the appropriateness of specific medical procedures or services. To contact the Medical Director, call 1-512-506-7000, and press "0" for the operator.
•Primary Care Provider and Hospital List. PCCM prepares and distributes to clients a listing of all PCCM providers. This listing identifies those providers who are accepting new patients, those who are accepting established patients only, and those who provide THSteps services. This listing is updated on a quarterly basis. To request a copy of the listing, contact the PCCM Provider Helpline at 1-888-834-7226 or visit the TMHP website at www.tmhp.com.
•Monthly Panel Report. PCCM provides to primary care providers a list of clients who have selected or who have been assigned to the primary care provider for management and coordination of their health care. This list is available online at www.tmhp.com, or by calling the PCCM Provider Helpline at 1-888-834-7226. Clients on this list are eligible for PCCM services throughout the entire month.
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