Get Maree Tmho Form

The Maree Tmho Form is essential for updating your provider enrollment information efficiently and accurately. This guide provides clear, step-by-step instructions on how to complete the form online, ensuring your details are current in the TMHP system.

Follow the steps to successfully complete the Maree Tmho Form online.

1. Click 'Get Form' button to obtain the Maree Tmho Form and open it in your editing tool.
2. Review the form's initial fields. Start by entering your Nine-Digit Texas Provider Identifier (TPI) and your National Provider Identifier (NPI). Ensure these numbers are correct for proper processing.
3. Provide your physical address. Remember that a PO Box cannot be used for this section. Fill in your street address, city, state, and ZIP code accurately.
4. If necessary, update your accounting/mailing address and attach a copy of the W-9 form if changes are made here.
5. Indicate the type of change you are requesting by checking the relevant box, such as a change of physical address or a change in provider status.
6. Complete the tax information section by entering your Tax Identification Number (TIN) and the exact name reported to the IRS for this number.
7. Review the demographic information and update as needed, including languages spoken, office hours, and whether you are accepting new clients.
8. Ensure you provide your signature and the date at the bottom of the form. Without this, the form may not be processed.
9. After completing the form, choose whether to save your changes, download a copy, print it, or share it as needed.

For a seamless process, complete your Maree Tmho Form online today.