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Reminder: HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

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Home and Community-based Services (HCS) providers, Texas Home Living (TxHmL) providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of Consumer Directed Services (CDS) employers must submit claims and forms to Texas Medicaid & Healthcare Partnership (TMHP) beginning May 2, 2022, for dates of service on or after May 1, 2022.

Steps to Prepare

Program providers, LIDDAs, and FMSAs are strongly encouraged to set up the following accounts if they have not already done so:

  • Claims Submission Account:
    • TexMedConnect or
    • Electronic Data Interchange (EDI)
  • Long-Term Care (LTC) Online Portal
  • TMHP Learning Management System (LMS)

Failure to set up the necessary accounts can lead to delays in payment after implementation. Program providers, LIDDAs, and FMSAs can find resources for creating the necessary accounts and the time frames it could take to create those accounts in the following table.

What You’ll Use

What It Does

Account Setup Resource

Time Frame

TexMedConnect

Allows users to submit claims

TMHP Account Setup for HCS and TxHmL Waiver Programs

Can take up to 10 days

EDI

Allows users to submit claims through a third-party submitter or a provider’s own software

Trading Partner Testing and Claims Submission Practice Now Available for HCS and TxHmL Programs

Can take up to 30 days

LTC Online Portal

Allows users to submit, view, and manage forms

TMHP Account Setup for HCS and TxHmL Waiver Programs

Can take up to 3 days

TMHP LMS

Allows users access to important TMHP training materials

Learning Management System (LMS) Registration and Navigation Job Aid for Providers

1 day

Providers should prepare for this transition by doing the following:

  • Keeping claims submissions current in Intellectual Disability Client Assignment and Registration (ID-CARE).
  • Submitting Intellectual Disability/Related Condition (ID/RC) and Individual Plan of Care (IPC) renewals in a timely manner.
  • Completing Client Assignment and Registration (CARE) data entry.
  • Reconciling any errors relating to location exceptions.

Training Resources

Providers can refer to the following training resources for more information about submitting claims and forms to TMHP:

Note: To access the LMS, users must have an account. Users can register for an account here. New TMHP LMS users can access the Learning Management System (LMS) Registration and Navigation Job Aid for Providers located on the LMS homepage or send an email to TMHP Training Support for support on creating an LMS account or navigating the LMS.

HCS and TxHmL providers are encouraged to sign up for GovDelivery electronic notifications for HHSC news and alerts. Additional articles and announcements for LTC program providers can be found in the “Recent News” section of the LTC homepage.

For additional questions, providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ), send an email to hcs_txhml@tmhp.com, or contact the TMHP EDI Help Desk at 888-863-3638.