The following can start trading partner testing and submitting practice claims:
- Texas Home Living providers
- Home and Community-based Services providers
- Local Intellectual and Development Disability Authorities
- Financial management services agencies billing on behalf of Consumer Directed Services employers who submit claims using TMHP’s Electronic Data Interchange
Providers and LIDDAs may use the 837P Long-Term Care (LTC) Companion Guide (PDF) to complete trading partner testing and practice submitting EDI claims to TMHP. Submitting practice claims is for EDI submitters only. TexMedConnect users are not able to submit practice claims.
Providers and LIDDAs that do not have an active TMHP or EDI account, need to do the following before starting trading partner testing or practicing claims submissions:
- Activate one, or both, of the following TMHP accounts by following the steps in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (PDF).
- Complete and submit the EDI Agreement (PDF) for each provider number (also known as contract number).
Providers using a third-party claims vendor on the Approved Vendor List (PDF) do not need to complete testing. Their claims vendor can begin submitting practice claims. Instructions for submitting EDI claims is in the TMHP EDI Connectivity Guide (PDF). Refer to the draft version of the HCS TxHmL Bill Code Crosswalk.
Providers that have submitted their EDI Agreement, and are using a third-party claims vendor not on the Approved Vendor List (PDF), can have their claims vendor begin testing by following these steps:
- Go to the TMHP EDI Testing website.
- Select the Register for a TMHP Community Account link to email an account request. Accounts are created within 24 hours of the submission.
- Begin trading partner testing.
- After testing is complete, the third-party claims vendor will need to complete and submit a TMHP EDI Gateway Trading Partner Enrollment Form and a Trading Partner Agreement for approval.
Once approved by the TPEF and TPA, the EDI Submitter ID is created. The claims vendor can start to submit practice claims with their EDI Submitter ID.
Providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ) (PDF) for more information They can also call the TMHP EDI Help Desk at 888-863-3638, Option 4.