How to Get Credentialed with Texas Medicaid in Texas
Quick Overview
Timeline
30 - 90 days
CAQH
Not Required
Re-credentialing
Every 5 year(s)
Delegated
No
Texas-Specific Requirements
Medicaid Information: Texas
Agency: Texas HHSC
Program: Texas Medicaid
Portal: https://www.tmhp.com/topics/provider-enrollment
Phone: 1-800-925-9126
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Texas.
Prepare Your Application
Complete Texas Medicaid's provider enrollment application with all required information and supporting documentation.
Submit Your Application
Submit your completed enrollment package to Texas Medicaid.
Track & Follow Up
Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Texas Medicaid?
Our specialists handle the entire Texas Medicaid enrollment process: applications, follow-ups, and approvals in Texas.
Required Documents Checklist
Background Check
Federal/state background check required for Medicaid enrollment
CV/Resume
Work history required
FINGERPRINT_CLEARANCE
ConditionalRequired for some provider types
Fingerprinting required for some provider types
Malpractice Insurance
ConditionalRequired in most states; some state programs waive for government employees
Medical License
NPI Certificate
Enrollment Forms
Texas Medicaid Provider Enrollment (TMHP)
RequiredFree Tools for Your Texas Medicaid Enrollment
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Key Credentialing Terms
- Capitation
- A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- Managed Care
- A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
- Network Adequacy
- The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
Credentialing Checklist
Make sure you have everything ready before applying to Texas Medicaid.
View Physician Credentialing Checklist →Contact Information
Provider Credentialing
National1-800-925-9126
Mon-Fri 8am-5pm
Provider Services
National1-800-925-9126
Claims & Billing
National1-800-925-9126
Quick Links
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.