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TMHP Learning
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Claims and Appeals

Provider Education
12 results returned

  • Medicaid Claim Appeals

    This training helps you understand how to appeal Medicaid claim decisions made by the Texas Medicaid & Healthcare Partnership (TMHP). You will also discover resources to help navigate the appeals process effectively.

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  • Paper Claim Forms

    This training offers essential best practices for paper claim form submissions. It covers detailed information on form fields for CMS-1500, UB-04 CMS 1450, Family Planning 2017, and ADA Dental forms, along with valuable resources to streamline your process.

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  • Crossover Claims

    Master the fundamentals of Medicare crossover claims. This training covers Medicare Parts A, B & C, QMB vs. MQMB clients, claim submission, and appeals. Gain the knowledge to streamline billing and ensure accurate reimbursements.

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  • Medicaid Basics

    The Medicaid Basics training offers an overview of Texas Medicaid, including TMHP's role, managed care, state health programs, Electronic Visit Verification, Medicare, provider enrollment, responsibilities, prior authorization, and claims. Ideal for new and existing providers.

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  • Audiovisual/Audio-only Behavioral Health Services Delivery

    Learn how delivering behavioral health services using audio-only and audiovisual technology offers flexibility and safety. Infographics and a video explain the policies and procedures for effective service delivery.As mandated by House Bill 4, passed by the 87th Legislature, Regular Session...

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  • YES Waiver

    The course aims to equip providers with the knowledge and tools necessary to successfully navigate the YES Waiver, ensuring effective service delivery and fostering community growth and support for children and families. This course covers the following topics: Introduction to...

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  • R&S Reports for Acute Care

    The Remittance and Status (R&S) training helps providers understand how to access and interpret R&S reports, which detail the status of claims, including pending, paid, denied, and adjusted claims.

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  • Third Party Liability

    The Third Party Liability (TPL) training educates providers on identifying other insurance and third-party resources. An overview on cost avoidance, cost recovery, and compliance with claim submission deadlines is also provided.

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  • MTP

    Enhance your understanding of the Medical Transportation Program (MTP). Learn about driver duties, Individual Transportation Plans (ITPs), and essential program components, while gaining the expertise needed to provide outstanding transportation services.

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  • TexMedConnect for LTC

    Simplify your workflow with TexMedConnect, the free, secure online tool designed for TMHP long-term care (LTC) providers. Enter, save, and submit claims, track statuses, make adjustments, and access R&S reports—all accessible anytime, anywhere.

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  • TexMedConnect for Acute Care

    Streamline operations with TexMedConnect, a free, secure online tool from TMHP. Accessible anywhere, it allows providers to verify eligibility, submit claims and appeals, track statuses, and access R&S reports—empowering efficient claims management.

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  • CSHCN Services Program

    The CSHCN Services Program Training helps providers serve children with special health care needs. It covers clients, benefits, enrollment, responsibilities, authorizations, claims, and appeals. Enhance your service delivery today!

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