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Medical Transportation program lodging provider enrollment application V1 Table of Contents Required Forms for Medical Transportation Program Enrollment. . . . . . . . . . . . . . . . . . . . . .
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. . . . . . . . . . . . . . . . . . . . . .2 Medical Transportation Program Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 1. General Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. Registration Process. 1. General. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.1 Required Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2.2 Additional Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.3 Cancellation. . . . . .

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TMHP (Texas Medicaid & Healthcare Partnership) form is a document used by healthcare providers in Texas to report and request reimbursement for services provided to Medicaid recipients.
Healthcare providers in Texas who provide services to Medicaid recipients are required to file the TMHP form.
To fill out the TMHP form, providers must provide accurate and complete information regarding the services provided, the Medicaid recipient, and the requested reimbursement. The form can be filled out electronically or manually with the required information.
The purpose of the TMHP form is to enable healthcare providers in Texas to report the services provided to Medicaid recipients and request reimbursement from TMHP.
The TMHP form requires the reporting of information such as the provider's identification information, the Medicaid recipient's information, the services provided, the dates of service, the diagnosis codes, and the requested reimbursement amount.
The deadline to file the TMHP form in 2023 may vary and should be in accordance with the guidelines and instructions provided by TMHP or the Texas Medicaid program. Providers are advised to consult the official resources for the most accurate and up-to-date deadline information.
The penalty for the late filing of the TMHP form may vary depending on the specific circumstances and policies of TMHP or the Texas Medicaid program. Providers should refer to the official guidelines and instructions for information on penalties and consequences for late filing.
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