TMPPM 2008 > Appendices > Women's Health Program > Benefits and Limitations

O.4.4 Eligibility Verification

The WHP Medicaid Identification card (Form H3087) visibly indicates the program in the black box in the upper right area of the card. The card also contains a notice to providers that WHP-covered services are limited to an annual visit and exam and contraception, except emergency contraception. Client eligibility may be verified using the following sources:

•www.tmhp.com.

•Automated Inquiry System (AIS).

•TDHconnect.

Refer to: "Eligibility Verification" for additional information.

WHP clients will have the following identifiers on the feedback received from the stated source:

•Medicaid Coverage: W - MA - WHP.

•Program Type: 68 - MEDICAL ASISTANCE - WOMEN'S HEALTH PR.

•Program: 100 - MEDICAID.

•Benefit Plan: 100 - Traditional Medicaid.

Providers must verify if a woman has been certified for the WHP prior to billing, or the claim may be denied. If a claim is denied prior to certification, providers can resubmit claims once a woman is certified.