TMPPM 2008 > Texas Medicaid Services > Texas Medicaid (Title XIX) Home Health Services > Enrollment

24.1.2 Pending Agency Certification

Home health agencies and DME-Home Health Services (DMEH) suppliers submitting claims before the enrollment process is complete or without authorization for services issued by TMHP Home Health Services Authorization Department will not be reimbursed. The effective date of enrollment is when all Medicaid provider enrollment forms are received and approved by TMHP.

Upon the receipt of notice of Medicaid enrollment, the agency/supplier must contact TMHP's Home Health Services Authorization Department before serving a Medicaid client for services that require a prior authorization number. Prior authorization cannot be issued before Medicaid enrollment is complete. Regular prior authorization procedures are followed at that time.

Home health agencies that provide laboratory services must comply with the rules and regulations of the Clinical Laboratory Improvement Amendments (CLIA). Providers who do not comply with CLIA will not be reimbursed for laboratory services.

Do not submit Home Health Services claims for payment until Medicaid certification is received and a prior authorization number is assigned.

Refer to: "Clinical Laboratory Improvement Amendments (CLIA)" .