TMHP EDI Overview and Advantage of Electronic Services (Texas Medicaid & Healthcare Partnership)

TMHP EDI program and the Health and Human Services Commission (HHSC) encourage providers to submit claims and other requests electronically. Providers can participate in the most efficient and effective method of submitting requests to TMHP by submitting through the TMHP Electronic Data Interchange (EDI) Gateway. TMHP EDI program uses the Health Insurance Portability and Accountability Act (HIPAA) compliant American National Standards Institute (ANSI) ASC X12 4010A file format through secure socket layer (SSL) and virtual private networking (VPN) connections for maximum security.

Advantages of Electronic Services

  • It’s fast. No more waiting by the mailbox or making telephone inquiries; know what’s happening to claims in less than 24 hours and receive reimbursement for approved claims within a week. TDHconnect users can submit individual requests interactively and receive a response immediately.
  • It’s free. All electronic services offered by TMHP are free, as well as the TDHconnect software and its technical support, upgrades, and training. TDHconnect users can access the TMHP website directly, without having to pay for an internet connection.
  • It’s easy. TMHP offers free workshops for TDHconnect, Medicaid, CSHCN Services Program billing, and many other topics, as well as a large library of reference materials and manuals.
  • It’s safe. TMHP EDI services use VPN and SSL connections, just like the U.S. government, banks, and other financial institutions, for maximum security.
  • It’s accurate. TDHconnect and many other software programs have features that let providers know when they’ve made a mistake, which means fewer rejected and denied claims. Rejected claims are returned with messages that explain what’s wrong, so the claim can be corrected and resubmitted right away.
  • It’s there when it’s needed. Electronic services are available day and night; from home, the office, or anywhere in the world.
  • It makes record keeping and research easy. Not only can software be used to send and receive claims, it can retrieve Electronic Remittance and Status (ER&S) reports, perform claim status inquiries, and archive claims. TDHconnect can generate and print reports on everything it sends, receives, and archives.

Leave a Reply

Your email address will not be published.

Post Navigation