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.
Beginning February 15, 2021, providers can submit complaints using the Email Us button on the TMHP Contact web page. For directions on how to use this new complaint submission feature, and more information on submitting complaints, refer to TMHP Complaints System Job Aid: Submitting A Complaint.
After the complaint is submitted, providers can select to receive confirmation by email or text message. When confirmation is received, providers can track the status of the complaint in their message dashboard.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.