The Prior Authorization (PA) Webinar is intended to educate Texas Medicaid and Children with Special Health care Needs (CSHCN) Services Program providers on prior authorization guidelines, processes, requirements, and tools available for submitting prior authorizations.
The Case Management for Children and Pregnant Women (CPW) Infographic contains a high-level overview on enrollment details, steps for enrollment, and steps for submitting a prior authorization. This document contains clickable hyperlinks that take you to important virtual destinations.
The PA on the Portal Submission Guide sets forth the procedures for online prior authorization requests, using the Texas Medicaid & Healthcare Partnership's (TMHP's) Prior Authorization (PA) on the Portal system.
This Ad-Hoc Computer-Based Training (CBT) module one covers the specifics of HHSC Family Planning Eligibility, as it pertains to providers and state staff. Module two (Contract Monitoring) covers the process of HHSC monitoring of contracted providers.
The PA on the Portal CBT contains an explanation of the PA process and three simulations that show users how to submit a PA request, check the status of a PA, and how to save a PA as a draft...
The TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG) contains information regarding creating Texas Medicaid & Healthcare Partnership (TMHP) accounts necessary for submitting claims and forms to TMHP.
This training manual provides detailed instructions on administrator and user functions and roles, activating a TMHP User account, managing user accounts and more.
The Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs is a two-part webinar for providers and Local Intellectual and Developmental Disability Authorities (LIDDAs).
The HCS and TxHmL TexMedConnect Claims Submission Webinar trains program providers, LIDDAs, and FMSAs on claims submission and management using TexMedConnect.
This CBT provides an overview of the rules, regulations, responsibilities for the program. It is intended for HHSC Family Planning Program providers. This CBT is not for Medicaid providers that provide family planning services through Medicaid.
How and when to appeal a claim, and when to escalate an appeal.
Texas Health Steps CBT contains information on topics that will demonstrate how the Texas health Steps program is building brighter futures by caring for Texas children.
The EVV Acronyms infographic provides definitions to frequently used acronyms related to Electronic Visit Verification (EVV).
The CSHCN Services Program Training presents information that provides new and current CSHCN Services Program providers with an overview of the program.
Initial Electronic Visit Verification (EVV) Portal Training for Program Providers affected by the 21st Century Cures Act. Previously live streamed October 28, 2020 and November 18, 2020
The Ambulance Basics CBT contains information for regarding policies and procedures for providing ambulance transports for Medicaid and CSHCN Services Program clients.
This CBT discusses procedures and general guidelines for submitting paper claims. This CBT does not discuss electronic claim submission. Refer to the TexMedConnect for Acute Care Providers CBT for information regarding electronic claim submission.
The Crossover Claims CBT provides an overview of the process for submitting claims and receiving reimbursement when a client has both Medicare and Medicaid.
The goal of this training is to discuss the various levels of claim appeals and methods for submitting them. In this training, we'll look at three different scenarios involving claim appeals.
The Third Party Liability (TPL) computer-based training (CBT) educates providers on TPL, identifying other insurance and third party resources (TPRs), and responsibilities for filing claims and reporting other insurance and TPR to TMHP.
The Remittance and Status Report CBT contains information for providers regarding how to access R&S Reports, including a description of the different sections of the R&S Report.for Medicaid and CSHCN Services Program Clients.
This CBT will introduce providers to the basics of enrolling and providing services and goods as a Medicaid DME provider.
