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 Regional Support for Territory 5

PR Rep Name:  Yvonne Garza-Garcia
Phone Number: TMHP Contact Center at 1-800-925-9126
TMHP-CSHCN Services Program Contact Center at 1-800-568-2413

Provider Relations Representatives are the field based Medicaid Training Specialists in Texas. They provide education and training on claims submission for new and existing Medicaid providers. Technical support and training are also provided for TexMedConnect software users for Medicaid, Long Term Care, Children with Special HealthCare Needs (CSHCN) Services Program, Medically Dependent Children’s Program (MDCP), Medical Transportation Program (MTP), Texas Women’s Health Program (TWHP) and Family Planning Providers.

For information on educational training workshops on claims submission for new and existing Medicaid providers please visit the Provider Education section of this website. The following are descriptions of some of the workshops TMHP offers throughout the year:

Educational Training Workshop Sessions

Staying informed is one of the most important aspects of participation in state health-care programs. TMHP recognizes that your time is valuable and offers a variety of ways to receive provider education. Live workshops off-site are conducted throughout each year. TMHP’s new education initiatives include webinars, online training modules (computer based trainings CBTs) and Radio TMHP podcasts. These trainings can be completed at your own pace and at a time that is convenient for you. All TMHP training is free. Free Provider Workshops can help you understand how to get paid for providing needed services to Medicaid and CSHCN Services Program clients. Participating in education training sessions can help you stay up-to-date:

  • Texas Medicaid Basics is a workshop/CBT designed for providers new to Texas Medicaid or for providers requesting a Medicaid refresher course. This education session will provide an overview of the Texas Medicaid program. Topics include: verify client eligibility and use the client eligibility data to determine program benefits, navigate the TMHP website, and enroll and/or credential to provide additional services.
  • Texas Medicaid: Beyond the Basics is an education workshop designed to explain advanced fundamentals of the Texas Medicaid policies and procedures to the more experienced provider. This workshop will focus on addressing topic points important to the more tenured Medicaid provider. This workshop will provide topics required to identify and resolve the top 5 provider related Explanation of Benefits/Explanation of Pending status, file Medicare crossover claims, and identify mass adjustments.
  • TexMedConnect is the TMHP application that provides support and training for transmitting electronic data. TMHP has a Computer Based Training (CBT) module that provides detailed training on installation, claims completion, transmission, client eligibility/MESAV, appeals/adjustments, claim status and more.

Provider Visits

You may contact your Provider Relations Representative for one-on-one provider visits or an in-service in your office. To request, confirm, or reschedule a visit, click here to email Provider Relations. Please include your name, contact number, and National Provider Identifier and Texas Provider Identifier (NPI and TPI) on all e-mails to ensure they are routed to the correct person.

Provider Enrollment

There are two ways providers may enroll:

  • To apply online, click here to activate your account. Follow the instructions for completing the online enrollment process. Download, print, and complete the application forms.
  • To submit a paper application, you will need to download the enrollment forms. You may access online 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

TMHP offers free of charge an online computer based training (CBT) that is available 24/7 on how to enroll online using the Provider Enrollment on the Portal (PEP) Computer Based Training.

 
 

 Counties

Brooks
Cameron
Duval
Hidalgo
Jim Hogg
Jim Wells
Kenedy
Kleberg
Starr
Webb
Willacy
Zapata

 

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