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ENROLLMENT PACKET FOR THE LOUISIANA MEDICAL ASSISTANCE PROGRAM (Louisiana Medicaid Program) Basic Enrollment Packet for Entities/Businesses (With Instructions) (Common Forms for All Entity Provider.

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The enrollment application fee for institutional providers for the calendar year 2022 has increased from $599 to $631. This application fee for institutional providers will be required in the following instances: Providers initially enrolling in Medicaid, Medicare, and the Children's Health Insurance Program (CHIP)

TMHP Application Fee for LTC Providers Each year, the Centers for Medicare & Medicaid Services publishes the application fee in the Federal Register 60 days before the new calendar year. The fee for calendar year 2022 is $631. The fee for calendar year 2021 is $599. The fee for calendar year 2020 is $595.

The enrollment application fee for institutional providers for the 2023 calendar year has increased from $631 to $688. This application fee will be required in the following instances: Providers initially enrolling in Medicaid and the Children's Health Insurance Program (CHIP)

YourTexasBenefits.com: You can upload your items online. Your Texas Benefits Mobile App: You can upload your items using the mobile app. Mail: HHSC, PO Box 149024, Austin, TX 78714-9968. Fax: 1-877-447-2839.

Questions? If you have further questions, please email LouisianaProvEnroll@gainwelltechnologies.com or call 833-641-2140, Monday – Friday between the hours of 8 a.m. and 5 p.m. Central time.

Make and document an eligibility decision on an application as soon as all required verification is received. Time frame for eligibility determination: Make an eligibility decision within 45 days on applications from applicants 65 years or older.

How to Enroll. Go to the Enrolling in the CSHCN Services Program page of the Texas Medicaid & Healthcare Partnership website. You can enroll online or print out the paper application form to complete and return to TMHP. If you have questions, call your local area TMHP provider relations representative.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232