Tmhp provider enrollment 2026

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The Texas Medicaid Provider Enrollment Application document provides detailed instructions and requirements for healthcare professionals seeking to enroll as providers in the Texas Medicaid program. It outlines the application process, necessary forms, enrollment criteria, and compliance with federal regulations such as the Affordable Care Act. The document emphasizes the importance of completing all sections accurately, submitting required documentation, and understanding provider responsibilities regarding claims submission and patient care. Additionally, it includes information on privacy rights, background checks for high-risk providers, and guidelines for maintaining eligibility within the program.

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Click ‘Get Form’ to open the tmhp provider enrollment application in the editor.
Begin by filling out Section A, which includes your Provider of Service Information. Ensure you provide accurate details about your practice type and specialty.
In Section B, complete the Disclosure of Ownership and Control Interest Statement. This section requires detailed information about ownership interests.
Proceed to Section C if you are enrolling as a group practice. List all performing providers associated with your group.
Complete Section D, the Provider Information Form (PIF-1), ensuring all fields are filled accurately, including your physical address where services are rendered.
Review the HHSC Medicaid Provider Agreement carefully and sign it to confirm your understanding and compliance with the terms.
Finally, attach any required documents such as the IRS W-9 form and submit your application through our platform for processing.

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