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EFT Submission Process During TMHP Provider Enrollment

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Effective December 1, 2020, if a provider submits a paper electronic funds transfer (EFT) form by mail or fax, after being enrolled in Texas Medicaid, TMHP will contact the authorized representative on file to confirm submission of the request. If TMHP cannot reach the authorized representative, the request to receive payment by EFT will be denied.

Authorized representatives of providers who use the Provider Information Management System (PIMS) to submit an EFT form will not be contacted by TMHP. Requests and documents submitted through PIMS are usually approved faster.

For more information about EFT and enrolling in EFT, providers can refer to the current Texas Medicaid Provider Procedures Manual, Section 1.2.3 EFT Enrollment Procedures.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.