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Electronic Data Interchange (EDI)

Providers that use third-party software and third-party vendors that submit claims for providers use the TMHP EDI gateway to submit claims to TMHP.

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Medicare Advantage Plan (MAP) Contractors

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HHSC has directed TMHP to allow Medicare Advantage Plan (MAPs) contractors to begin EDI testing. The MAPs must have entered into a formal agreement with HHSC to begin EDI testing. Providers must contact the MAPs for detailed information about HHSC agreements and testing statuses.

A list of approved Medicare Advantage and Dual Eligible Health Plans can be found on Texas Health and Human Services' Managed Care Contract Management webpage. The list can be found under the "Other Resources" section.