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Revised THSteps Dental Mandatory Prior Authorization Request Form
Information posted May 2, 2008: This is an update to a banner message that first appeared on the March 7, 2008, Remittance and Status (R&S) report about the revised THSteps Dental Mandatory Prior Authorization Request Form. The banner message stated that the revised form would be required effective May 1, 2008. That date has changed; TMHP will accept only the revised form effective September 1, 2008. On or before August 31, 2008, either form may be used. The banner message also stated the form would be published in May/June 2008 Texas Medicaid Bulletin, No. 215. The form was not published in this bulletin but will be published in the July/August 2008 Texas Medicaid Bulletin, No. 216. Click on the title to view the complete, revised banner message.

TMHP has revised the THSteps Dental Mandatory Prior Authorization Request Form found in Appendix B-71 of the 2008 Texas Medicaid Provider Procedures Manual. Effective September 1, 2008, TMHP will only accept the revised form. Authorization requests submitted on the old form will not be processed and the provider will be notified to resubmit the request on the revised form. Click here  to view the revised form.

The updated form is also available through the TMHP fax-back option. The fax-back option is available by calling the Automated Inquiry System (AIS) at 1-800-925-9126. To use fax-back, follow these steps:

1.      Have your 9-digit Texas Provider Identifier number available.

2.      At the first automated menu prompt, select Option 1 for automated services.

3.      After your provider number has been accepted, select Option 6 at the next automated menu, and follow the instructions. The THSteps Dental Mandatory Prior Authorization Request Form is document number 122.

For more information, call the TMHP Contact Center at 1-800-925-9126.
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