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December 2016 Texas Medicaid Provider Procedures Manual

Section 4: Client Eligibility : 4.5 CHIP Perinatal Program : 4.5.3 Client Eligibility Verification : Eligibility Verification for Clients Without a Medicaid ID
Providers should first attempt to verify if a Medicaid number has been issued by calling TMHP at 1‑800‑925-9126 and using the prompt for AIS or speaking to a representative. Providers can also use TexMedConnect to check client eligibility. If a provider is unable to locate a Medicaid number for the mother or infant 45 days after form H3038 or H3038P was faxed, the provider can contact the HHSC Central Processing Center (CPC) in one of the following ways:
CPC needs the following information to respond to requests or inquiries. Providers should submit the information only once. All submissions must be sent in a secure manner. If there are multiple inquiries that are over 45 days, providers can submit them together.
Required information includes the following:
CPC will research inquiries and respond to the provider within 10 business days. This time frame is an approximation and may only apply if all information, including complete contact information, is provided and fewer than 25 names were submitted.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.