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.
Texas Medicaid & Healthcare Partnership (TMHP) is experiencing an unusually high volume of calls from providers with questions about the Provider Enrollment and Management System (PEMS).
As a result, there may be delays in receiving a callback from a Provider Relations representative.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.