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Texas Department of State Health Services (DSHS) Many of the direct client services that were performed by DSHS, such as services for women and children, and people with special health care needs, were transferred to HHSC in September 2016.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
The largest provider of Medicaid and CHIP coverage in Central Texas, Superior HealthPlan, was not chosen by Texas' Health and Human Services Commission to continue as a Medicaid or CHIP provider ...
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
Conflicting information, computer systems not working, denials before verification and more problems come to the surface from whistleblowers, advocacy groups.
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