Form 1344, Managed Care Resources Update Request

Instructions for Opening a Form

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Documents

Effective Date: 7/2022

Instructions

Update: 7/2022

Purpose

Managed care organizations (MCO) use this form to submit revisions to HHSC of the pharmacy resources available at txvendordrug.com.

When to Prepare

MCOs staff complete one copy of the form per managed care program (e.g., submit one form for STAR, CHIP, STAR+PLUS, etc.). 

Detailed Instructions

Fields not applicable to your MCO program should remain blank.

  • Contact Information
    • MCO submitter completes all fields.
  • MCO General Information
    • Complete all fields, and identify the managed care program applicable to this form.
  • Claims Billing Information.
    • Complete all fields as necessary.  Identify the "BIN Number" (field 1Ø1-A1), "Processor Control Number" (1Ø4-A4), and "Group ID" (field 3Ø1-C1) pharmacies staff use to submit claims to the MCO.
  • Pharmacy Enrollment Information.
    • Complete all fields as necessary.
  • DME Enrollment Information.
    • Complete all fields as necessary.
  • Call Center Information.
    • Complete all fields.
  • Website Information.
    • Complete all fields as necessary.

Transmittal

The MCO sends the form to the Vendor Drug Program via email at vdp_mco_solutions@hhsc.state.tx.us.

Questions