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Get Tmhp Short Application Form
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How to fill out the Tmhp Short Application Form online
Filling out the Tmhp Short Application Form online is a straightforward process designed to assist users in enrolling to provide critical health services. This guide offers a step-by-step approach to ensure that users can complete each section accurately, promoting a smooth application experience.
Follow the steps to complete the Tmhp Short Application Form online.
- Click the ‘Get Form’ button to access the application form and open it for editing.
- Begin with the Contact Information section. Provide your full legal name, business address, phone number, and email address, ensuring all details are accurate and complete.
- Proceed to the Provider of Service Information section. Here, include your provider type (individual, group, or facility) and any specific details required for your type of service.
- Complete the Disclosure of Ownership section. Ensure to provide complete and accurate details about ownership and control interests, which includes any direct or indirect ownership details.
- If applicable, fill out the Group Practice section with the names and identifiers of all performing providers within the group.
- For each Principal in your entity, complete the Principal Information Form (PIF-2) to outline their respective ownership stakes.
- Review the Provider Agreement to understand your obligations. Sign the agreement to confirm your acceptance of the terms and conditions outlined.
- Finally, save your completed application. You may have options to download, print, or share the form with relevant stakeholders.
Ready to submit your application? Complete the Tmhp Short Application Form online today!
Most people who have Medicaid in Texas get their coverage through the STAR managed care program. STAR covers low-income children, pregnant women and families. STAR members get their services through health plans they choose.
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