Provider Services. Option 6: Other Insurance. No fee schedules, basic unit, relative values or related listings are included in CDT. Members can get oral interpretation services and information in other formats, like … 1-877-687-1196. ALL rights reserved. The sole responsibility for the software, including any CDT and other content contained therein, is with TMHP or the CMS; and no endorsement by the ADA is intended or implied. Option 6: Accounts Receivable and Financial Transactions. Send us an email by clicking the button below, or select from one of the available telephone lines. DataLogic issues notice of data security incident. Select type of provider from the options below: Create Account and link to an Acute Care provider. To request enrollment assistance please contact the TMHP Contact Center at 1-800-925-9126 or TMHP CSHCN Services Program Contact Center at 1-800-568-2413. Getting to the doctor, dentist or drugstore. Applications are available at the American Dental Association web site, http://www.ADA.org. The scope of this license is determined by the ADA, the copyright holder. The ADA does not directly or indirectly practice medicine or dispense dental services. If the provider is not enrolled or you do not have coverage for the date(s) of service, you will be responsible for the bill. Providers can call Provider Services at 1-800-454-3730, Monday through Friday from 8 a.m. to 7 p.m. Central time with questions about eligibility, benefits, claims, or any other issue. This Agreement will terminate upon notice if you violate its terms. For assistance with technical questions. For submitting a claim appeal via phone. Healthy Texas Women (HTW): HTW women's health and family planning services: Other Services Offered: Federal Re-enrollment Complete: Federal Re-enrollment Date: Providers - Click here to update your information. For assistance with enrollment applications, updates to new and existing provider accounts, and enrollment policy. Important telephone numbers for Texas Medicaid and CSHCN Services Program clients. Phone Number * "Confirm Phone Number" must be completed properly before submitting. The hotline is staffed with nurses who are knowledgeable about Medicaid and CHIP benefits and services. If you still need help: STEP 2: Contact HHSC. Texas Health Steps877‑847‑8377 Get And Sign Texas Medicaid Provider Enrollment Application TMHP com 2014-2021 Form . For answers to questions about other insurance information and updates. For a menu of automated information available through the AIS system. You can also contact Provider Services at the appropriate number below. Create Account and link to a Long Term Care provider. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. If the Contact Center representative determines th at an inquiry can best be handled by the TMHP Provider Relations department, the inquiry will be forwarded to Provider Relations. The AMA is a third party beneficiary to this Agreement. Patient Gender Served: Patient Age Served: -. Representatives will assist with claim research, prior authorization information, policy, and billing. Applications are available at the American Medical Association website, www.ama-assn.org/go/cpt. Questions? Please note: that additional credentialing is not required for those providers already credentialed in the STAR, CHIP, or STAR Kids networks and whose credentialing is current. The Contact Center is open from 7:00 a.m. to 7:00 p.m., Central Time, and can assist both providers and clients. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. AMA/ADA End User License Agreement Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government Use. The TMHP Contact Center is staffed with agents that are knowledgeable about Texas Medicaid, the Children with Special Health Care Needs (CSHCN) Services Program, Healthy Texas Women (HTW) and the Family Planning Program. For help re-enrolling, contact a TMHP provider enrollment representative at 1-800-925-9126, Option 2. The nurses can respond to calls from providers and members seeking clinical information, guidance on specialty referrals or requests for specialty provider consultations. The AMA does not directly or indirectly practice medicine or dispense medical services. Option 3: Electronic Data Interchange (EDI) Help Desk. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the American Medical Association (AMA) is not recommending their use. CSHCN Services Program providers can call this line for assistance from 7:00 a.m. to 7:00 p.m., Central Time. For questions about authorization and prior authorization requests. To request a fair hearing. Provider Services: Visit our Dentists' page for state specific contact information. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). The NPI is the National Provider Identifier, and is a unique identification number provided to facilities and other medical entities. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal Procurements. This line assists providers with claim related inquires, such as claim status, appeal process, and claim submission instruction. Contact Provider Services for information or questions on benefits, claims, authorizations and billing inquiries. Contact Us. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. people who are 20 or younger. The following options are available: Option 1: Automated transactions. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, 515 N. State Street, Chicago, Illinois, 60610. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights included in the materials. Activate My Account Try Again. To use a general fee schedule, Medicaid providers can click Static Fee Schedules. Providers may contact Molina Provider Services to obtain information regarding Claims, Complaints and Appeals, Member Eligibility, Benefits, Utilization Management, Quality Improvement, Prior Authorizations and Referrals. All rights reserved. Option 8: Third Party Resource (TPR). us to be approved. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "accept". In the event of an outage contact Provider Relations at 888-243-3312 or CCHPProviderRelations@cookchildrens.org LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT® "). Option 3: Authorizations. BY CLICKING BELOW ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT. The Center for Medicaid and CHIP Services (CMCS) is committed to working in close partnership with states, as well as providers, families, and other stakeholders to support effective, innovative, and high quality health coverage programs. By mail—find the correct address in the “appeals” section of the Texas Medicaid Provider Procedures Manual . Managed Care Contact Information Medicaid providers, including pharmacies, who want to contract with a medical or dental managed care plan must contact the managed care organization (MCO) of their choice to complete a separate contract and credentialing application in addition to enrolling with TMHP. This product includes CPT which is commercial technical data and/or computer databases and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Agents can assist with claims filing, financial inquiries, eligibility, and provider education. I want to create an account to administer an existing enrolled Texas Medicaid and other state healthcare programs provider. Tell us if you or your children have any special needs, like a wheelchair or a walker, so we can send the right type of vehicle. CPT is a registered trademark of American Medical Association. 4. This product includes CDT, which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Dental Association, 211 East Chicago Avenue, Chicago Illinois, 60611. For applicable claims refer to the Texas Medicaid Provider Procedures Manual. Provider Services (855) 322-4080 Dallas, Bexar, … The Texas Health and Human Services Commission (HHSC) has contracted with LogistiCare to manage Medicaid non-emergency medical transportation services (NEMT) for Texas Medicaid members, Children with Special Health Care Needs (CSHCN) program members … If you are a Texas Medicaid Provider you must create a Provider Administrator account to access these secure functions. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, 515 N. State Street, Chicago, Illinois, 60610. 800-925-9126. or write to: TMHP, Complaints Resolution Department PO Box 204270, Austin, TX, 78720-4270. Agents can answer questions about maintenance of provider accounts, completing a Texas Medicaid program application, and policies that affect enrollment. provider manual or website. All other users can search for fees by provider type and specialty. You can have a video or phone visit with a doctor using your phone or computer with Superior telehealth services at 1-800-835-2362. For accounts receivable, payment status, and check history information. U.S. … Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. CPT only copyright 2020 American Medical Association. If you are a provider and need to reach CFHP after hours or on weekends, please call (210) 227-2347 . If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "ACCEPT". ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. For the latest COVID-19 news, visit the CDC. Austin, TX 78720-2018. The ADA is a third party beneficiary to this Agreement. Network providers must update their enrollment and demographic information with Texas Medicaid Healthcare Partnership (TMHP) beginning April 1, 2021. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. Option 6: Electronic Health Records (EHR) Incentive Program. For questions about provider enrollment. or Insurance Premium Payment Assistance questions, TMHP HIPP/IPPA Client Helpline800‑440‑0493 If you do not agree to the terms and conditions, you may not access or use the software. CDT is a trademark of the ADA. PO Box 202018 U.S. GOVERNMENT RIGHTS. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer databases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. For general inquiries and information about LTC claims, verification, and nursing facility forms. The TMHP Contact Center is staffed with agents that are knowledgeable about Texas Medicaid, the Children with Special Health Care Needs (CSHCN) Services Program, Healthy Texas Women (HTW) and the Family Planning Program. Provider Relations: 800-341-8478 Join Our Networks: Visit our Dentists' page. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. IF YOU DO NO AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. TMHP-CSHCN Services Program Client Line 877‑888‑2350 (7 a.m. to 7 p.m. Central Time, Monday to Friday) Medical and dental checkups and health care for people who are 20 or younger. Option 3: Authorizations. Some Medicaid client data was affected. Members should call Member Services with any questions. Log in to your account and send us a message. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. This Agreement will terminate upon notice to you if you violate the terms of the Agreement. Option 5: Healthy Texas Women (HTW) and the Family Planning Program.For questions about the HTW and the Family Planning Programs, such as policies, benefits, and prior authorizations. Call your provider's office right away. Shortness of breath. Call or write us! THE LICENSE GRANTED HEREIN IS EXPRESSLY CONTINUED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. Click here to Create a Provider Administrator Account Option 3: Provider Enrollment. Providers must call the TMHP-CSH CN Services Program Contact Center at 1-800-568-2413 to speak to a representative who can answer questions. For EDI Help Desk assistance with TexMedConnect access and EDI issues, such as: resetting passwords, Internet requirements, EDI enrollments, transmission verifications, file rejections, software requests, file resets, technical problems within the TMHP website, and electronic Remittance and Status (ER&S) Report downloads. Applications are available at the American Medical Association website, www.ama-assn.org/go/cpt. Is Medicare Provider Number same as NPI? Option 2: Nurse. Make a copy of the bill. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. Superior HealthPlan operates a toll-free nurse hotline that providers and members can call 24-hours-a-day, 7 days a week. tx. Member Services: 1-800-600-4441 (TTY 711) STAR Kids members: 1-844-756-4600 (TTY 711) Already a member? End Users do not act for or on behalf of the CMS. Write a letter addressed to Client Correspondence including the date you told the provider you/your child are/is a client of Texas Medicaid. Option 1: General inquiries. You can have a video or phone visit with a doctor using your phone or computer with Superior telehealth services at 1-800-835-2362 . CDT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The TMHP Provider Information Management System (PIMS) User Guide (PDF) provides guidance on submitting demographic updates to TMHP. Providers can locate more information about TMHP Provider Information Management System (PIMS) on tmhp.com. 2. Please note that some claims cannot be appealed by phone. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Medical and dental checkups and health care for Links to each of these search methods are found at the top of the Online Provider Lookup pages. Note: This is also used when issuing the retro-authorization as HHS will only authorize the Texas Medicaid and Healthcare Partnership (TMHP) to grant an authorization for the exact items that were approved by the plan. Contact Us. (7 a.m. to 7 p.m. Central Time, Monday to Friday). Providers may contact HHSC at the following address: Texas Health and Human Services Commission Mail Code 91X P.O. If you think you might have been exposed, contact a doctor immediately. We’ll also ask you for the date, time and reason for your visit. 877-888-2350 Here you'll find phone numbers, addresses, emails and other contact information to help support providers. Urgent Care Center? For other complaints such as provider enrollment and re-enrollment, or traditional Medicaid claims: Call. Medical Transportation Program877‑633‑8747. To enroll in Texas Medicaid YES Waiver providers must contact DSHS at YESWaiver dshs. For questions about current and past eligibility for Medicaid clients. Make sure they know you or your child are on Medicaid or the CSHCN Services Program and that they have your client ID number. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. This provider line offers general information concerning Texas Medicaid, Texas Healthy Women, and the Family Planning Program. Give us the name, address and phone number of the doctor, dentist office, drug store or place you plan to go. Click here for more information and benefit updates. Please contact the Provider Hotline at 800-214-4844 from 8:00AM – 5:00PM, Monday – Friday. Option 4: Electronic Data Interchange (EDI). For inquiries requiring the assistance of a TMHP nurse. You, your employees and agents are authorized to use CPT only as contained in materials on the Texas Medicaid & Healthcare Partnership (TMHP) website solely for your own personal use in directly participating in healthcare programs administered by THHS. Option 2: Claims Status. Children's Health Insurance Program (CHIP). For questions about prior authorization requests, including appropriate submission format, instruction clarification, and the appeal process. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. To check the status of your submission, call... Medicaid Helpline The Contact Center is open from 7:00 a.m. to 7:00 p.m., Central Time, and can assist both providers and clients. These materials contain Current Dental Terminology, Fourth Edition (CDT), Copyright © 2020 American Dental Association (ADA). Not a Community First Health Plans Provider? Phone—through the TMHP Contact Center at 1-800-925-9126. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. 5. The COVID-19 Vaccine will be available to health plan members at zero out-of-pocket cost. UnitedHealthcare is here to help providers who may need information, service or support on network management, provider contracting and more. 3. For a menu of automated information available through the AIS system. If you think you might have been exposed, contact a doctor immediately. The bill should include: Name and client ID number or Social Security Number, Date and any amount of payments you have made on the account. Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid. Client Eligibility Lookup For current eligibility status, please enter 2 of the following 4 data elements for the Client: Patient Control Number state. If possible, include the name of the person you spoke with at the provider's office. Finding services in your area such as child care. 800-335-8957 Technical Support for Filing Claims: 888-863-3638 Option 5: Fair Hearing. Coughing. Option 2: Enrollment. TMHP - Basic Provider Search Instructions: To find a doctor, hospital or other participating provider we offer two (2) search methods. Ambetter from Superior HealthPlan. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. Providers who have an account on TMHP.com can log into their accounts to search for the fees that apply specifically to them. Utilization Management: 800-294-9650: Main Corporate Phone: 800-417-7140 Corporate Headquarters: DentaQuest 465 Medford Street The responsibility for the content of this product is with THHS, and no endorsement by the AMA is intended or implied. For information about the EHR incentive program that is available for eligible Medicaid providers. Planning procedure codes. Instead, you must exit from this computer screen. select one of the following options: Option 1: Client Eligibility. Aetna Better Health of Texas is not responsible or liable for non-Aetna Better Health content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Texas Health Steps 877‑847‑8377 (8 a.m. to 6 p.m. Central Time, Monday to Friday) Health Insurance Premium Payment Program Click here for more information. 1. In order to expedite your call, please have the following: Tax Identification number, NPI, member ID, DOB, billed amount and date of service available. Form Completed By * ... (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at the Member Services number on the back of your Superior ID card to speak directly to a customer service representative. Option 7: Electronic Visit Verification (EVV). (7 a.m. to 7 p.m. Central Time, Monday to Friday), Questions about CSHCN Services Program benefits. For example, Contact a TMHP provider enrollment representative for assistance at 800-925-9126, Option 2 Submit general re-enrollment question via email or request a PEP application walk-through at: Provider.Enrollment.Mailbox@tmhp.com Send a secure email to HHSC at hpm_complaints@hhsc.state.tx.us CMS DISCLAIMER. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Option 4: Telephone Appeals. (8 a.m. to 6 p.m. Central Time, Monday to Friday), Health Insurance Premium Payment Program (7 a.m. to 7 p.m. Central Time, Monday through Friday), TMHP-CSHCN Services Program Client Line Medicaid Helplines800‑335‑8957 and 800‑252‑8263 For questions about benefit limitations for Medicaid services and client dental history. (7 a.m. to 7 p.m. Central Time, Monday to Friday), TMHP-CSHCN Services Program Client Line877‑888‑2350 The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. Providers can choose from the following options: Option 1: Automated inquiries. Option 2: Provider Inquiries. For questions about EVV. (7 a.m. to 7 p.m. Central Time, Monday to Friday), Supplemental Security Income (SSI) questions, Social Security Administration800‑772‑1213, TMHP Personal Care Services Line888‑276‑0702. Option 5: Benefit Limitations and Dental History. Enroll as a Texas Medicaid Provider/Vendor. If the provider is enrolled and you are covered for the date(s) of service, follow these steps: Client Correspondence Representatives are ready to answer questions and resolve issues for all CSHCN Services Program matters. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Welcome to the LogistiCare web site for Texas Medicaid clients, medical providers and non-emergency medical transportation providers. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago IL 60611. Mail the copy of the bill and your letter to Client Correspondence. For questions about a Medicaid client’s other insurance information, assistance with other insurance verification, and other insurance updates.
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