Currently, PCCM clients who change their primary care provider are notified on their Medicaid Identification (ID) Form (Form H3087).

Beginning on November 1, 2007, if a change of primary care provider is successful, the notification letter will list the name of the new provider and the effective date. Clients will be instructed to take both the PCCM notification letter and their Medicaid ID Form (Form H3087) to the new provider’s office.

Providers can verify eligibility using any of the following options:

·         Verify the client’s Medicaid ID Form and ask if they have recently requested a change. If so, use one of the other options to verify the primary care provider.

·         Verify electronically through TMHP Electronic Data Interchange (EDI) Gateway.

·         Call the Automated Inquiry System (AIS) at 1-800-925-9126.

·         Call the PCCM Provider Helpline at 1-888-834-7226.

Some provider change requests made by clients cannot be processed. A notification letter will be sent to clients whose provider change request was not successful. Most unsuccessful provider changes occur because clients lose their Medicaid eligibility before the change can be made.

For more information, call the PCCM Provider Helpline at 1-888-834-7226.