Get Texas Medicaid Tp 1 Form Access Texas Medicaid Tp 1 Editor

Get Texas Medicaid Tp 1 Form

The Texas Medicaid TP 1 form is an essential document used to request authorization for initial outpatient therapy services under the CSHCN Services Program. Completing this form accurately is crucial, as any omissions can lead to claim denials. For assistance, individuals can reach out to the TMHP-CSHCN Services Program Contact Center during business hours.

Access Texas Medicaid Tp 1 Editor
Content Navigation

The Texas Medicaid TP 1 form, officially known as the CSHCN Services Program Authorization Request for Initial Outpatient Therapy, is an essential document for families seeking therapy services for children with special health care needs. This form must be completed accurately and submitted in its most recent version to ensure proper authorization for outpatient therapy services, including physical therapy, occupational therapy, and speech-language pathology. Each section of the form requires specific client information, such as the child's name, date of birth, and diagnosis code. Additionally, the form includes a section for evaluation summaries, which necessitates attaching a copy of the initial evaluation. Proper documentation of service requests, including procedure codes and frequency of therapy sessions, is crucial, as incomplete submissions can lead to claim denials. The form also requires signatures from the prescribing physician and relevant therapists, along with detailed provider information. For assistance, families can contact the TMHP-CSHCN Services Program Contact Center during business hours. Submissions can be made by mail or fax, but only the authorization form should be sent—instruction pages are not necessary.

Dos and Don'ts

When filling out the Texas Medicaid TP 1 form, consider the following guidelines:

  • Use the latest version of the TP 1 form available on the TMHP website.
  • Complete all sections of the form to avoid denial of your request.
  • Print or type all information clearly to ensure readability.
  • Attach the initial evaluation as required; failure to do so may delay processing.
  • Contact the TMHP-CSHCN Services Program for assistance if you have questions.

Additionally, here are some things to avoid:

  • Do not submit instruction pages along with the authorization form.
  • Avoid leaving any fields blank as this can lead to incomplete requests.
  • Do not exceed the six-month limit for dates of service.
  • Do not forget to include the required signatures from all relevant providers.
  • Do not use incorrect modifiers for therapy services; ensure you use GP for PT and GO for OT.

Get Answers on Texas Medicaid Tp 1

What is the Texas Medicaid TP 1 form?

The Texas Medicaid TP 1 form, also known as the CSHCN Services Program Authorization Request for Initial Outpatient Therapy, is a document used to request authorization for outpatient therapy services for clients enrolled in the CSHCN Services Program. This form must be filled out completely and accurately to ensure that the request is processed without delays.

Where can I find the TP 1 form?

The most recent version of the TP 1 form can be found on the TMHP website at www.tmhp.com . It's important to use the latest version to avoid any issues with your submission.

What information do I need to provide on the form?

You will need to provide various details about the client, including:

  • First and last name
  • CSHCN Services Program number
  • Date of birth
  • Address, city, and ZIP code
  • Diagnosis code relevant to the client’s condition

Additionally, you must include information about the evaluation, service requests, and provider details.

What happens if I don’t complete the form correctly?

Incomplete authorization requests will lead to claim denials. It is crucial to fill out every section of the form and to ensure that all information is accurate. If you have questions while completing the form, you can contact the TMHP-CSHCN Services Program Contact Center for assistance.

How do I submit the TP 1 form?

You can submit the TP 1 form in several ways:

  1. By mail to the TMHP-CSHCN Services Program Authorization Department at 12357-B Riata Trace Parkway Ste #100 MC-A11, Austin, TX 78727.
  2. By fax to 1-512-514-4222.

Remember to submit only the authorization form and not any instruction pages.

What additional requirements should I be aware of?

When requesting authorization for physical therapy (PT) and occupational therapy (OT) services, you must use the appropriate modifiers. Specifically, use the GP modifier for PT and the GO modifier for OT. For speech-language pathology (SLP) services, the GN modifier is required. Make sure to include these modifiers in your service request to avoid any issues with authorization.

How to Use Texas Medicaid Tp 1

Filling out the Texas Medicaid TP 1 form is an essential step in the process of obtaining authorization for initial outpatient therapy services. To ensure that your request is processed smoothly, follow the steps outlined below carefully. Each section of the form must be completed accurately, as any omissions could lead to delays or denials of your request.

  1. Obtain the most recent version of the TP 1 form from the TMHP website at www.tmhp.com.
  2. Print or type all information clearly on the form.
  3. In the Client Information section, fill in the following fields:
    • First name
    • Last name
    • CSHCN Services Program number
    • Date of birth
    • Address, City, and ZIP code
    • Diagnosis code relevant to the client’s condition
  4. In the Evaluation Summary section, provide:
    • Date of evaluation (attach a copy of the initial evaluation)
    • Type of evaluation (check the appropriate box for PT, OT, or SLP)
    • Any additional comments
  5. In the Service Request section, indicate:
    • Procedure code(s) and modifier
    • Dates of service (ensure they do not exceed six months and ideally end on the last day of a month)
    • Frequency of services per week or month
  6. Provide the names, signatures, and dates for the following individuals:
    • Physician
    • Physical Therapist (PT)
    • Occupational Therapist (OT)
    • Speech Language Pathologist (SLP)
  7. In the Provider Information and Required Signature section, fill in:
    • Provider name
    • CSHCN TPI
    • NPI
    • Taxonomy code
    • Benefit code
    • Provider contact name
    • Telephone number
    • Fax number
    • Provider's address, city, and ZIP code
  8. Ensure the provider signs and dates the form.
  9. Submit the completed form by mail or fax:
    • Mail to: TMHP-CSHCN Services Program Authorization Department, 12357-B Riata Trace Parkway Ste #100 MC-A11, Austin, TX 78727
    • Fax to: 1-512-514-4222

Common mistakes

Filling out the Texas Medicaid TP 1 form can be a straightforward process, but many people make common mistakes that can lead to delays or denials of service. One frequent error is not using the most recent version of the form. The Texas Medicaid Healthcare Partnership (TMHP) updates forms periodically. Submitting an outdated version can result in automatic rejection of the request.

Another common mistake is leaving sections incomplete. Each part of the TP 1 form must be filled out entirely. Incomplete forms will be denied, causing frustration and potential delays in receiving necessary therapy services. Always double-check that every section is addressed before submission.

Many individuals also overlook the requirement to attach a copy of the initial evaluation. The form specifies that this documentation is mandatory. Without it, the request cannot be processed. This oversight can lead to unnecessary back-and-forth communication with the TMHP, wasting valuable time.

Additionally, people often fail to provide accurate diagnosis codes. This information is crucial for the authorization process. If the codes do not match the client's condition or are entered incorrectly, the claim may be denied. Take the time to verify that the diagnosis code is correct and corresponds to the evaluation.

Finally, not including the required signatures can halt the process entirely. Each professional involved—physician, physical therapist, occupational therapist, and speech-language pathologist—must sign the form. Missing signatures will lead to immediate rejection. Ensure that all necessary parties review and sign the form before submission to avoid delays.

More PDF Forms