Provider Enrollment | El Paso Health

Enrolling in Texas Medicaid is a prerequisite for enrolling in other state health-care programs. By becoming a provider for Texas Medicaid and other state health-care programs, each provider has the opportunity to improve the health and well-being of Texans in their community.

The Texas Medicaid Healthcare Partnership (TMHP) is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information.

You can update your enrollment and demographic information with TMHP. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs.

Step-by-Step Provider Enrollment Guide

To Providers: Please update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs.
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The TMHP Provider Enrollment webpage can be accessed at the following URL: https://www.tmhp.com/topics/provider-enrollment

To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the Provider Enrollment and Management System (PEMS) web page at the following URL: https://secure.tmhp.com/pems

The Step-by-Step Guide can be accessed at the following URL: https://www.tmhp.com/topics/provider-enrollment/pems/start-application
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This page includes step-by-step instructions for maintenance requests as well as new enrollment, existing enrollment, revalidation, and reenrollment. Select the link under Existing Enrollment to access instructions for adding new practice locations or to submit a change of ownership.

Select the link under Maintenance to access instructions for updating demographic data.This page also provides links to the Enrollment Help page and the TMHP YouTube channel. TMHP’s Provider Enrollment and Management System (PEMS) tool can be found here.

The TMHP YouTube channel has a playlist dedicated to PEMS. The playlist can be accessed here:

TMHP PEMS Playlist

Additional provider enrollment help can be found here:

TMHP Provider Enrollment Help

Otherwise, you can contact TMHP directly at 800-925-9126 for assistance (option 3).

Out of Network Provider Enrollment

If a Provider or Facility is not a contracted Provider, the Provider/Facility must contact the El Paso Health Contracting and Credentialing Department regarding set up.

Out of Network Providers may submit the Provider Demographic Form, W-9 Form, and Texas Provider Identifier (TPI) Letter via email to Contracting_Dept@elpasohealth.com or by fax to 915-298-7870.
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Provider Demographic Form

W9 Form – Request for Taxpayer Identification Number and Certification
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To be reimbursed for services rendered to Medicaid Members, Provider must be enrolled in Texas Medicaid.

If an Out of Network Provider does not have a TPI number, the provider will not be eligible for reimbursement for services to a member participating in the STAR Medicaid Program.

An Out of Network Provider must notify the El Paso Health Contracting and Credentialing Department of the TPI assignment through a formal written notification which may be the Texas Medicaid & Healthcare Partnership (TMHP) approval letter.

Out of Network Providers are subject to non-participating provider authorization and reimbursement guidelines.
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For more information, please reference the Out of Network Provider–Texas Provider Identifier section in the Provider Manual, which can be found on the Provider Materials page.