Updates and Actions Required for Implementation of PEMS Master Provider File Regarding Address Differences
ATTENTION COMMUNITY FIRST PROVIDERS Collaborative testing between Texas Health and Human Services Commission (HHSC) and Managed Care Organizations (MCOs) has identified Provider address differences between the MCOs ecosystem and the Master Provider File (MPF)...TMHP Provider Enrollment and Management System (PEMS)
Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ...