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Texas Medicaid Patient Verification
Verify electronically through TMHP EDI. Providers may inquire about a patient’s eligibility by electronically submitting one of the following for each patient:
Texas Medicaid & Healthcare Partnership Contact Center
12357-A Riata Trace Parkway
Suite 100 Austin, TX 78727
Providers can obtain patient eligibility information for a patient who is enrolled in a Medicaid managed care organization (MCO) from the MCO’s web page. Providers can also check the MCO’s web page for submission of electronic claims, prior authorization requests, claim appeals and reconsiderations, exchange of clinical data, and other documentation necessary for prior authorization and claim processing.
Advantages of Electronic Eligibility Transactions
Eligibility transactions through TexMedConnect or EDI have the following advantages: