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Texas Medicaid and CHIP

Contact Us

General Administrative Questions

Contact Center General Inquiries Line: (800) 925-9126

Or

Contact Center webpage

Claims Administration and Provider Enrollment

Texas Medicaid & Healthcare Partnership (TMHP) website (opens new window)
TMHP is the Claims Administrator for Texas Medicaid.

Technical Support for Claims Filing: (888) 863-3638

Claims Filing for Managed Care Services

Claims for services administered by a medical or dental plan must be submitted to the plan.  Providers may submit managed care claims by the following: 

  • Submit acute, long term services, or dental claims directly to the appropriate medical or dental plan using the methods established by the plan.
  • Submit acute care or dental claims electronically to TMHP for routing to the appropriate medical or dental plan. 

Office of Community Access and Services

Regional Community Relations specialists foster partnerships with stakeholders to improve delivery and access to Medicaid and CHIP services. These specialists are located throughout the state and link government resources to families, medical and dental providers, hospitals, faith- and community-based organizations, schools and others to promote improvements to the health care system. The specialists provide information about Medicaid and CHIP, offer assistance in organizing community events and coordinate public meetings, including Medicaid and CHIP Regional Advisory Committee Meetings. Learn more about the Office of Community Access and Services

Complaints, Appeals and Provider Resolution Division

Fee-For-Service

Medicaid fee-for-service providers must exhaust the administrative and medical appeals provider resolution process with the HHSC claims administrator contractor before filing an appeal or complaint with HHSC.  Written appeals and complaints may be sent to HHSC at:

Texas Health and Human Services Commission
HHSC Claims Administrator Contract Management
PO Box 204077, Mail Code 91-X
Austin, Texas 78720-4077

Medicaid Managed Care

Medicaid managed care providers must exhaust the complaints or grievance process with their managed care medical or dental plan before filing a complaint with HHSC.  If after completing this process, the provider believes they did not receive full due process from the managed care medical or dental plan, they may file a STAR, STAR+PLUS, or managed care dental complaint or inquiry at  HPM_complaints@hhsc.state.tx.us or a STAR Health complaint or inquiry at STAR.Health@hhsc.state.tx.us.

Providers may also mail STAR, STAR+PLUS, STAR Health or children’s Medicaid dental services complaint or inquiry to:

HHSC Medicaid/CHIP
Health Plan Management
Mail Code H-100
P.O. Box 85200
4900 N. Lamar       
Austin, Texas 78708-5200

Providers can submit appeals directly to the medical or dental plan that administers the clients’ managed care benefits.  Claims that were originally submitted to TMHP for routing to the appropriate medical or dental plan can be appealed to TMHP using TexMedConnect or EDI.  The appeals will be routed to the appropriate entity for processing.

For additional information visit the Texas Administrative Code, 1 TAC 354.

CHIP call center: 1-877-543-7669 or 1-800-647-6558
CHIP processing center:                

HHSC
P.O. Box 14200
Midland, TX 79711-4200

HHSC Ombudsman Office

Contact the Ombudsman Office if you have health and human services-related complaints or issues.

Texas Health and Human Services Commission
Office of the Ombudsman, MC H-700
P O Box 13247
Austin, TX  78711-3247

Phone: 1-877-787-8999 (Toll-Free)
Texas Relay: 7-1-1 or 1-800-735-2989 (Toll-Free) For the deaf or hearing impaired
Online: Online Submission Form  
Fax: 1-888-780-8099 (Toll-Free)

HHSC Civil Rights Office

Call the Civil Rights Office if you need to talk to someone about concerns of discrimination or would like to file a discrimination complaint.

Civil Rights Office
Health and Human Services Commission
701 W. 51st Street, MC W206
Austin, Texas 78751
1-888-388-6332 or 1-512-438-4313
TTY toll-free: 1-877-432-7232
HHSCivilRightsOffice@hhsc.state.tx.us

HHSC Headquarters
Texas Health and Human Services Commission
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78751-2316
Main number: 512-424-6500
Media calls: 512-424-6951

Directions and maps to HHSC headquarters and other Austin facilities

Report waste, fraud, or abuse

You can report suspected fraud, waste, or abuse in Texas health and human services programs by filling out an online form or by calling 800-436-6184. You may also make a report to the Texas State Auditor's Office by calling 800-TX-AUDIT.