My Account is the main account that all providers must have to use any of TMHP’s portals, including Prior Authorization on the Portal, Provider Enrollment on the Portal, and TexMedConnect.
For more information about how to setup and use My Account, providers can refer to:
TexMedConnect is an online application that lets providers file claims, check claims status, confirm client eligibility, and more. There are two versions of TexMedConnect—acute-care and long-term care.
For more information about how to setup and use the acute care version of TexMedConnect, providers can refer to:
- TexMedConnect–Acute Care Manual
- TexMedConnect User Guide for Managed Care Organization (MCO) Long Term Services and Supports (LTSS) Providers
- STAR Kids MCO Training Manual – TMHP Web Security and Permissions
For more information about how to setup and use the long-term care version of TexMedConnect, providers can refer to:
Provider Information Management System (PIMS)
Providers can use PIMS to keep their provider enrollment information up-to-date, including information covered on the Provider Information Change (PIC) Form, information about Electronic Funds Transfer (EFT), and more. For more information about how to use PIMS, provider can refer to the Provider Information Management System (PIMS) User Guide.
Six Month Verification
Certain provider types must verify or update key demographic information every six months in PIMS to ensure that their information is correct in the Online Provider Lookup (OPL). These provider types include, but are not limited to, physicians, nurses, dentists, and durable medical equipment providers.
If more than six months have elapsed since a provider has verified the required demographic information in PIMS, TMHP blocks access to many functions on the secure provider portal until the verification takes place.
Instructions on how to verify and update demographic information can be found in the Provider Information Management System (PIMS) User Guide.