• Marketplace Provider Manual
• Quick Reference Guide
• HEDIS Quick Reference Guide
• Top 10 Suggestions for Documentation
• Chasing the Chart
• ICD-9 to ICD-10 Crosswalk General Equivalence Mappings (GEMS)
• Clinical Practice Guidelines Clinical and Preventive

Provider Appeals

• Provider Appeal Form

Provider Payment Dispute

• Provider Payment Dispute Form

Prior Authorizations

• Prior Authorization Determinations
• Prior Authorization Guide Effective 01/01/2021
• Prior Authorization Guide Effective 09/29/2020
• Prior Authorization Guide Effective 01/01/2020

Member Requests

• Member Request to Change Primary Care Provider

Member Appeals

• Member Appeal form - English
• Member Appeal form - Spanish

Medicaid/CHIP Provider Profile

• Member Reassignment Form
• Member Education Form
• SPC Consult Form

Prior Authorizations

• Prior Authorization Determinations
• Prior Authorization Guide Effective 01/01/2021
• Prior Authorization Guide Effective 09/29/2020
• Prior Authorization Guide Effective 01/01/2020

MAXIMUS’ THSteps Form

• THSteps Provider Outreach Referral Form Instructions
• THSteps Provider Outreach Referral Form

Manuals

• Provider Manual
• Texas Medicaid Uniform Managed Care Manual
• Texas Medicaid Provider Procedure Manual
• TMHP Manual

Links

• Texas Health and Human Services Commission
• Texas Medicaid & Healthcare Partnership
• Texas Medicaid/CHIP Vendor Drug Program

Quick Reference Guides

• CHIP Perinatal Quick Reference Guide
• CHIP Quick Reference Guide
• HEDIS Quick Reference Guide
• THSteps Quick Reference Guide
• STAR Quick Reference Guide
• THSteps Medical Checkup Billing Procedure Codes
• THSteps Medical Checkup Periodicity Schedule
• Community's THSteps Resource Guide
• Member Safety Plan

Synagis Program

• Synagis: Texas Medicaid STAR/CHIP
• Synagis Prior Authorization Request Form
• Synagis: Texas Vendor Drug Program

Clinical Practice Guidelines

• Clinical and Preventive
• ICD-10 Preparation

Provider Complaints

• How to Submit a Complaint as a Medicaid Provider

Provider Appeals

• Provider Appeal Form

Provider Payment Dispute

• Provider Payment Dispute Form

Member Requests

• Member Request to Change Primary Care Provider

Provider Manuals

• Provider Manual
• Provider Orientation
• Model of Care for Out of Network Providers
• Care Transitions & Continuity of Care Training for Providers, Office Staff, and FDRs
• Cultural Competency

Prior Authorizations

• Prior Authorization Determinations
• Prior Authorization Guide Effective 01/01/2021
• Prior Authorization Guide Effective 09/29/2020
• Prior Authorization Guide Effective 01/01/2020

Quick Reference Guides

• Quick Reference
• Waiver of Liability

Clinical Practice Guidelines

• Clinical and Preventive

Provider Appeals

• Provider Appeal Form

Provider Payment Dispute

• Provider Payment Dispute Form

Member Requests

• Member Request to Change Primary Care Provider