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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 1: Provider Enrollment and Responsibilities : 1.1 Provider Enrollment : 1.1.5 Required Enrollment Forms : 1.1.5.11 Copy of License/Temporary License/Certification

1.1.5.11
Providers who must be licensed or certified in Texas must submit a copy of their current license or certification.
Once a provider is enrolled in Texas Medicaid, a reminder letter will be automatically generated and sent to the provider 60 days before the provider's license expires.
TMHP directly obtains licensure information from the following licensing boards:
TMHP does not directly obtain licensure information from the following license boards:
Dentists, psychologists, chiropractors, and podiatrists must submit a paper copy of their licenses at the time of renewal to maintain a current record with TMHP.
Dental providers are required to send TMHP a letter from the Texas State Board of Dental Examiners (TSBDE) to verify current licensure for the State of Texas. This process is required to prevent potential claim denials due to the provider having an expired license on file with TMHP.
The letter must contain the provider's specific identification information, license number, and licensure period. The general letter provided on the TSBDE website will not be accepted by TMHP as proof of current licensure. Providers must call the number provided on the general letter to receive a letter that is specific with their individual provider information.
Important:
Providers are also required to submit to TMHP, within 10 days of occurrence, notice that the provider's license or certification has been partially or completely suspended, revoked, or retired. Not abiding by this license and certification update requirement may impact a provider's qualification to continued participation in Texas Medicaid.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.