Important: You must be enrolled in Traditional Medicaid before enrolling in CSHCN or Texas Health Steps. Select "Add to an Existing Enrollment," then click "Apply Filters" if you would like instructions for adding CSHCN or Texas Health Steps to your existing enrollment.
Page Filters
These pages will guide you through each stage of the enrollment process using PEP. To customize this page's content, use the filters below and click the Apply Filters button.
Application Type:
Program(s):
Enrolling As:
Signatures and Attachments
Instructions for Completing the Signatures and Attachments page.
Note: This page does not apply to Ordering and Referring Providers.
Select a name from the “Name of Authorized Signatory" drop-down menu.
The drop-down menu will be automatically populated a list of the names of the principals that you provided in the application.
If you don’t see a principal’s name on the list, then the principal must complete a PIF-2.
Enter the User ID of each assigned signatory in the “User ID of Authorized Signatory” field of each agreement.
Note: Each signatory must have a Portal User ID to access the electronic signature fields. For more information about creating portal accounts, refer to the TMHP Portal Security Provider Training Manual.
Click Validate Portal User ID. The email address for the User ID will be displayed, and a "Clear" button will be enabled.
Click Activate Agreement for E-Signatures.
The "Agreement", "Status", and "Remind/Re-Send Email" links will appear.
PEP will send an email to the email address that you provided. The email prompts the user to log in and sign the agreement.
In the Link to Agreement column, select Click Here to E-Sign. Adobe E-Sign will open in a new tab.
If you have more than one agreement to sign, all of the agreements will be automatically populated in one e-sign window for your review and approval.
Click Start. The First Name and Email fields will appear and will be automatically populated with the information that you previously entered
Verify that the populated fields are correct.
If the populated fields are not correct, click Clear.
Click OK. All of the fields and your selections will be cleared.
Return to the “Name of Authorized Signatory” drop-down menu, and start the process over.
Enter your TPI in the “Medicaid TPI” field (if applicable).
Note: This field will be automatically populated for re-enrollments. The field cannot be changed.
Click Next.
Click Click here to sign on the Applicant’s Signature line. The EchoSign pop-up window will appear.
Enter your full name in the “Name” field.
The enrolling provider must sign their name on this line.
The authorized representative must sign their name on this line. The authorized representative must have already completed a PIF-2.
Click Apply.
Click Next until you see an option to "Click to Sign."
Click Click to Sign. A message that states that you have successfully signed the application will display.
Click Download a copy if you want a copy for your records.
Close the EchoSign pop-up window to save your agreement. The status of the agreement will change to “Signed,” and “Click Here to E-Sign” will be disabled.
Section: Required Documentation
Complete and attach any of the listed documents that are required for this enrollment application
Section: Attachments
Important: All of the other required documentation must be either uploaded electronically or faxed/mailed
Click Browse.
Select your file and click Open.
Click Add Document. The document will be displayed under “File Name.”
Click Browse and upload all of your document PDFs.
Section: Agreement
Click I Decline or I Agree.
Note: All fields and buttons will be greyed out.
Click OK.
Warning: Once you submit the application, you can’t modify it.
Contents
Go directly to a specific page's instructions by using the links below.
