At the time of this recording, Texas Provider Identifiers (TPIs) were used as a provider identifier. As of December 2021, Texas Medicaid & Healthcare Partnership (TMHP) only uses National Provider Identifiers (NPIs) and Atypical Provider Identifiers (APIs).

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. Topics include:

 

  • Identify general Medicaid prior authorization guidelines
  • Identify CSHCN Services Program authorization and prior authorization guidelines
  • Understand timelines for processing authorizations and prior authorizations
  • List the methods for requesting authorization and prior authorization
  • Access PA on the Portal
  • Submit a request via PA on the Portal
  • Perform searches for and review prior authorizations online
  • Understand common reasons authorizations and prior authorizations are denied
  • Include essential fields on prior authorization submissions

 

Updates to programs, policies, and procedures discussed in this activity can be found on the TMHP website in the most currently published provider manuals, web articles, and banner messages.