TMHP EDI Claims Submission Methods
TMHP EDI Claims from providers can be submitted either using software (to submit files directly to TMHP) or they may use a billing agent (i.e., billing companies, vendors, or clearinghouses) that submits files on the provider’s behalf.
TMHP EDI Claims Submission – Software
Providers that intend to use TMHP’s electronic services need software to create, submit, and retrieve data files. Providers can use TDHconnect (TMHP’s free software) or the software from any vendor listed on the TMHP website on the EDI Submitter List. Providers who plan to use a billing agent to submit EDI transactions to TMHP should contact that organization for details on software requirements.
TDHconnect is the versatile, reliable, and free Windows®-based claims submission software provided by TMHP. Technical support, upgrades, and training for TDHconnect are also available free from TMHP. TDHconnect has a wide variety of features, some of which are not available in most vendor software. Providers can use the software to submit claims, eligibility requests, CSIs, adjustments, appeals, and retrieve ER&S reports. The program includes a reference database of current billing codes, procedure codes, Explanation Of Benefit (EOB) codes, and much more. Providers can even use TDHconnect to interactively submit individual claims that are processed in seconds.
Before attempting to install TDHconnect, verify that the computer on which it is to be installed meets the minimum software and hardware requirements listed on the order form. TDHconnect 3.0 is not supported on non-Windows® operating systems or on systems that do not meet the minimum system requirements.
A basic knowledge of Windows® operating systems is required to use TDHconnect 3.0. TDHconnect 3.0 works with a standard telephone line and existing internet connections. Providers in rotary dial areas cannot use the direct dial features of TDHconnect 3.0, but may use another existing internet connection.
Providers may also use vendor software to access TMHP’s electronic services. There are hundreds of vendors with a wide assortment of services that have been approved to submit electronic files to TMHP. A complete list of vendors that have completed the testing process and have been certified by TMHP can be found on the TMHP website at www.tmhp.com/edi. TMHP does not make vendor recommendations or provide any assistance for vendor software. Not all vendor software offers the same features or levels of support. Providers are encouraged to research their software thoroughly to make certain it can meet their needs and that it has completed testing with TMHP.
TMHP EDI Claims Submission – Billing Agents
Billing agents are companies or individuals that submit electronic files to TMHP on behalf of the provider. Generally, this means that the provider uses a product that sends billing or other information to the billing agent that processes it and then transmits it to TMHP and other institutions. TMHP has no information on the software or other requirements of billing agents. Providers should contact the billing agent to obtain information about their products and processes. A complete list of billing agents that have completed the testing process and have been certified by TMHP can be found on the TMHP website on the EDI Submitter List at www.tmhp.com/edi. TMHP does not make billing agent recommendations or provide any assistance for billing agents’ software or services.