Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, 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.
The Texas Medicaid & Healthcare Partnership (TMHP) is experiencing an unusually high volume of calls and emails from providers with requests for Provider Enrollment and Management System (PEMS) assistance.
As a result, TMHP requests the following of providers requiring PEMS assistance:
- TMHP encourages providers that request PEMS assistance to wait for a call back. Requests are being handled in the order they are received.
- TMHP requests that providers not initiate a second request. Duplicate requests can cause delays.
- While waiting for PEMS assistance, providers should refer to the following PEMS educational materials that may assist with PEMS enrollment, reenrollment, revalidation, change of ownership, and maintenance requests (maintaining and updating provider enrollment record information).
PEMS Training Materials Available on the TMHP Learning Management System (LMS)
The following training materials are available in the PEMS Learning Path on the TMHP LMS to help providers learn how to navigate and use PEMS:
- PEMS webinar recordings
- Provider Frequently Asked Questions (FAQ) about PEMS
- The following computer-based training (CBT) modules:
- “General Information”
- “New Enrollment”
- “Provider Management”
- PEMS Video Series
- Video entitled “PEMS vs. PEP” (PEP is the old system and it stands for Provider Enrollment on the Portal)
- “Quick Start Guide to Using PEMS”
- “PEMS Best Practices Guide”
Note: Providers must have a username and password to access the above materials on the LMS. To learn how to obtain a username and password, click here.
Informational Videos Available on the TMHP YouTube Channel
- “The Benefits of PEMS”
- “Removal of TPI from Forms”
- “TMHP Secure User Account”
- “Message Dashboard in TMHP User Account”
- “PEMS Dashboard Overview”
- “PEMS Navigation Panel”
- “Resolving Deficiencies”
- “Start New Enrollment”
- “Adding Attachments”
- “Signing Agreements”
- “TMHP Website: Overview”
- “TMHP Website: Provider Manuals”
- “TMHP Website: Provider Relations”
- “TMHP Website: Provider Notifications”
- “TMHP Website: My Account”
- “TMHP Website: Topics”
- “TMHP Website: Programs”
- “TMHP Website: Provider Enrollment”
- “TMHP Website: Resources”
Get More Information
Additionally, the following information related to PEMS is available on the TMHP website:
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.