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 OPL Data Must Be Verified Every Six Months

Beginning March 24, 2011, providers with certain provider types must ensure that their information is correct in the Online Provider Lookup (OPL) by verifying or updating key demographic information every six months in the Provider Information Management System (PIMS). Affected provider types include, but are not limited to, physicians, nurses, dentists, and durable medical equipment providers.

If more than six months have elapsed since the required demographic information in the OPL has been verified, providers will find that access to many functions on the secure provider portal have been blocked. Access remains blocked until the account administrator goes to PIMS and verifies or updates the necessary information.

Non-administrative users must let their account administrators know that PIMS needs to be verified or updated. To identify the administrator for an account, the non-administrative user can:

  • Click the National Provider Identifier (NPI) on their “Review Required” page.
  • Click Provider Administrator Lookup from the “My Account main” page.

Changing an Account Administrator

If the administrator on an account needs to be removed or updated, providers must submit the following information on facility or company letterhead by mail or fax to TMHP:

  • Provider’s Texas Provider Identifier (TPI).
  • Provider name.
  • Instructions to remove the current administrator.
  • List the administrator name.
  • Contact name, title, fax number, phone number.
  • The primary contact’s signature.

Information can be faxed to:   1-512-514-4228

Information can be mailed to:
Texas Medicaid & Healthcare Partnership
Attn: EDI Help Desk MC-B14
P.O. Box 204270
Austin, Texas 78720-4270

The provider will be notified by fax when the process has been completed.

Important: If information for the account administrator needs to be updated, please submit the request as soon as possible. The updating process can take up to 30 calendar days.

Existing Users Becoming Account Administrators

A user that has an existing account can create an administrative account by clicking on “Administer a Provider Identifier Link” on the “My Account” home page and following the prompts.

Creating a New Account

If a provider does not have an account on the secure provider portal on the TMHP website, the provider can create an account by clicking on the “I would like to” link on any of the Medicaid provider pages on the TMHP website and then clicking “Activate my account.” The user who creates the account will be designated as the administrator for that provider identifier.

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