Service Agreement Provider Contract With Medicare In Texas
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The state of Texas manages Medicaid, and program eligibility is based on income level. The federal government administers Medicare.
The Texas Medicaid & Healthcare Partnership (TMHP) is a group of contractors that administer Texas Medicaid, other state health care programs, and maintain state-owned Texas Medicaid systems on behalf of the Texas Health and Human Services Commission (HHSC).
State of Texas Access Reform (STAR) Managed Care Program (Medicaid)
Time frame for eligibility determination: Make an eligibility decision within 45 days on applications from applicants 65 years or older.
In Texas, there are 5 different types of Medicaid: Traditional Medicaid. STAR. STAR Kids. STAR Health. STAR+PLUS.
To begin the enrollment, visit the TMHP How to Apply for Enrollment page . All providers will use the Provider Enrollment and Management System (PEMS) to complete the enrollment process. Resources for enrollment: TMHP provider enrollment representative at 800-925-9126, Option 3.
You must complete the Provider Applicant Competency training (PAT) exam with a passing score of 85% or above. After you've completed the PAT, download the certificate showing your passing score. Any application submitted without a certification showing completion of the PAT with a passing score will not be accepted.
