Get Texas Medicaid Provider Enrollment Application Ordering - Tmhp.com

This guide aims to assist health-care professionals in successfully completing the Texas Medicaid Provider Enrollment Application for Ordering and Referring Providers. Understanding this process is essential for those seeking to participate in the Texas Medicaid program.

Follow the steps to complete your Texas Medicaid Provider Enrollment Application online.

1. Click the ‘Get Form’ button to access the Texas Medicaid Provider Enrollment Application and open it for editing.
2. Begin by filling in the medical identification section. Identify your provider type by checking the appropriate box that indicates the nature of your professional enrollment.
3. Indicate the reason for your enrollment request by selecting one of the following options: updating current information, applying for new enrollment, or withdrawing from billing to enroll as an ordering/referring provider only.
4. Complete Section A with your provider demographic information. Ensure all required fields are filled accurately. Each Provider must also fill out the Ordering/Referring Provider Information Form (OR-PIF) prior to submission.
5. Read and sign the HHSC Medicaid Provider Agreement for Ordering/Referring Providers, confirming your understanding and agreement with the enrollment terms.
6. Provide a point of contact for any queries related to your application, including alternative address details for correspondence about the application status.
7. Complete the Ordering/Referring Provider Identification Form with all required details, ensuring you use your legal name as per IRS records.
8. Once all sections are completed, review all the information for accuracy. Retain a copy of the submitted application and its attachments for your records.
9. Submit your completed application and any required forms to the Texas Medicaid & Healthcare Partnership at the provided mailing address.
10. After submission, monitor for any updates or letters regarding the status of your application. If approved, you will receive your ordering/referring TPI.

Complete your Texas Medicaid Provider Enrollment Application online today for streamlined enrollment.