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How to become a provider for medicaid 2026

Here's how it works

  • 01. Edit your provider medicaid number online

    Type text, add images, blackout confidential details, add comments, highlights and more.

  • 02. Sign it in a few clicks

    Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

  • 03. Share your form with others

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How to use or fill out how to become a provider for Medicaid with DocHub

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  1. Click ‘Get Form’ to open the Texas Medicaid Provider Enrollment Application in our platform.
  2. Begin by filling out the 'Provider of Service Information' section. Enter your existing Texas Provider Identifiers (TPIs) and National Provider Identifier (NPI) if applicable.
  3. Complete the 'Required Forms for Medicaid Enrollment' checklist, ensuring you have all necessary documents like the Texas Medicaid Identification Form and IRS W-9 Form ready for upload.
  4. In the 'Disclosure of Ownership and Control Interest Statement', provide accurate details about ownership interests. This is crucial for compliance.
  5. Review all entries carefully. Use our editor's features to highlight any sections that need attention or clarification before finalizing your application.
  6. Once completed, save your document and utilize our signing feature to add your signature where required. Ensure all signatures are original as per requirements.
  7. Submit your application by mailing it to the Texas Medicaid & Healthcare Partnership at the provided address, ensuring you keep a copy for your records.

Start using our platform today to streamline your Medicaid provider enrollment process!

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HCU UUHP - Provider Credentialing Application

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