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Provider Relations Support for Out-of-State Providers

 Support for Out-of-State Providers

PR Rep Name: To Be Determined
TMHP Medicaid Contact Center at 800-925-9126
CSHCN Service Program Contact Center at 800-568-2413

Provider Relations Representatives provide education and training for Texas health care program providers. The programs include Traditional Texas Medicaid, the Children with Special Healthcare Needs (CSHCN) Services Program, Healthy Texas Women (HTW), Family Planning, Long-Term Care (LTC), and Texas Health Steps Medical and Dental. Provider Relations Representatives train and assist new and existing providers regarding health-care guidelines and provide technical support for the TMHP Portal and TexMedConnect software.

Using the TMHP portal gives providers the ability to request prior authorization, submit provider file updates, access online enrollment and revalidation tools, and many other functions. The TexMedConnect software provides the ability to submit claims, check claim status, submit claim appeals, verify client eligibility, and view Remittance and Status (R&S) Reports.

For more information regarding Texas Medicaid or TMHP, please review the Texas Medicaid Provider Procedures Manual (TMPPM) or access the Learning Management System (LMS) available on the Provider Education page of this website. The following are some of the Computer Based Training (CBT) modules that are available anytime:

  • Ambulance Basics
  • Claim Appeals for Medicaid
  • Claim Forms
  • Crossover Claims
  • How to Use a CBT
  • Introduction to Medicaid Basics
  • Prior Authorization
  • Prior Authorization (PA) on the Portal
  • Remittance and Status Report
  • TexMedConnect for Acute Care Providers

Provider Visits

To request, confirm, or reschedule a Provider Relations Representative visit, click here to email your request. Please include your name, contact number, National Provider Identifier (NPI) and Texas Provider Identifier (TPI) on all emails to ensure they are routed to the correct representative.

Provider Enrollment:

You may access online enrollment and re-enrollment applications through the Provider Enrollment section of this website. The Contact Center is also available to answer your questions about completing the application or the status of your application at 1-800-925-9126 or to assist you with the enrollment process.


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