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1.1 TMHP-CSHCN Services Program Contact Information
1.1.1 TMHP-CSHCN Contact CenterThe TMHP-CSHCN Contact Center is available Monday through Friday, 7 a.m. to 7 p.m., Central Time, and is the main point of contact for the CSHCN provider community. The toll-free telephone number is 1-800-568-2413.
1.1.2 TMHP-CSHCN Automated Inquiry System (AIS)Dial 1-800-568-2413 (toll-free) to access the TMHP-CSHCN Automated Inquiry System (AIS). The call is answered automatically. Follow the directions to access AIS and use the automated features to obtain information and services.
The TMHP-CSHCN AIS provides the following information and services through the use of a touch-tone telephone: claim status, patient eligibility, current weekly payment amount, faxed forms, and claim appeals.
The TMHP-CSHCN AIS is available 24 hours a day, 7 days a week for eligibility and claim status infor-mation. For all other information, the TMHP-CSHCN AIS is available from 7 a.m. until 7 p.m., Central Time, Monday through Friday. AIS offers 15 transactions per call.
Note: Press Star/Pound (*#) to repeat any information given. Press Star/Star (**) to begin again if an error was made. Press Zero and Pound (0#) at any time to repeat the main menu.
Full instructions on the use and benefits of the TMHP-CSHCN AIS can be found in the Automated Inquiry System (AIS) User’s Guide available on the TMHP website at www.tmhp.com, by calling the TMHP-CSHCN Contact Center at 1-800-568-2413, or in Appendix A, “CSHCN Automated Inquiry System (AIS) User’s Guide” of this manual.
Important: Due to the implementation of recent improvements in the system, the User Guide as printed in Appendix A of this manual may be out of date.The TMHP website or the TMHP-CSHCN Contact Center are better sources for the most recent version of the Automated Inquiry System (AIS) User Guide.
1.1.3 TMHP Regional RepresentativesTMHP provider relations representatives provide a variety of services designed to inform and educate the provider community about the CSHCN Services Program policies and claims filing procedures. Technical support and training are also provided for TDHconnect software users. Provider relations representatives assist providers through telephone contact, onsite visits, and scheduled workshops. The table below indicates the TMHP provider relations representatives and the areas they serve. Additional information, including a regional listing by county and workshop infor-mation, is available on the TMHP website at www.tmhp.com/Providers/default.aspx. Click on the TMHP Provider Services Representatives link listed under Provider Resources on the TMHP website.
Territory Regional Area Provider RepresentativeTelephone Number
1 Amarillo, Childress, and Lubbock Elizabeth Ramirez 1-512-506-6217
2 Midland, Odessa, and San Angelo Diane Molina 1-512-506-3423
3 Alpine, El Paso, and Van Horn Isaac Romero 1-512-506-3530
4 Del Rio, Eagle Pass, and Laredo Francisca Sanchez 1-512-506-7271
TMHP and DSHS Contact Information
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1.2 DSHS-CSHCN Central and Regional Offices
1.2.1 Central OfficeThe central and regional offices of the CSHCN Services Program are administratively located within the Division for Family & Community Health Services, Specialized Health Services Section, Purchased Health Services Unit, at the Department of State Health Services (DSHS). Regular office hours are 8 a.m. to 5 p.m., Central Time, Monday through Friday.
TMHP is the claims administrator, and questions concerning provider enrollment, benefits or coverage, claims processing, and authorizations or prior authorizations should be directed to TMHP. DSHS-CSHCN welcomes other provider comments and suggestions. Contact DSHS-CSHCN using the following information:
• Telephone toll-free at 1-800-252-8023 (may be used only in Texas) or the Austin local number is 1-512-458-7111, Ext. 3099
6 Abilene and Wichita Falls Matthew Cogburn 1-512-506-7095
7 Brady, Brownwood, Hospitals in Travis County, Round Rock, and Waco
Andrea Daniell 1-512-506-7600
8 Austin, Bryan, College Station, and Wharton
Will McGowan 1-512-506-3526
9 San Antonio and Kerrville Sue Lamb 1-512-506-3422
10 San Antonio, Corpus Christi, and Victoria
Jill Ray 1-512-506-3554
11 Cleburne, Denton, and Fort Worth Rita Martinez 1-512-506-7990
12 Dallas, Corsicana, and Groesbeck Sandra Peterson 1-512-506-3552
13 Dallas and Whitesboro Olga Fletcher 1-512-506-3578
14 Tyler, Texarkana, and Paris Trilby Foster 1-512-506-7053
15 Beaumont and Lufkin Gene Allred 1-512-506-3425
16 Houston and Conroe Linda Wood 1-512-506-7682
17 Houston and Katy Rachelle Moore 1-512-506-3447
18 Galveston and Matagorda John Miller 1-512-506-3586
19 Houston Stephen Hirschfelder 1-512-506-3446
Territory Regional Area Provider RepresentativeTelephone Number
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• Mail to the following address:
Department of State Health ServicesCSHCN Services Program, MC-1938
ATTN: Provider Relations1100 West 49th StreetAustin, TX 78756-3179
Additional information about the CSHCN Services Program is available online at www.dshs.state.tx.us/cshcn.
1.2.2 Regional OfficesCase management and client eligibility services are provided by a statewide network of regionally based social service program consultants and include the following activities:
• Coordination of medical services
• Linkage to available resources
• Acting as a liaison among the child, family, and caregivers
• Management of institutional services, insurance carriers, and other services required for the improved well-being of the child and family
Refer to: Appendix B, “Acronyms and Initials Dictionary” for definitions of the abbreviated academic degrees listed in the following tables.
1.2.2.1 Region 1
1.2.2.2 Region 2
Canyon Regional Sub-Office (Canyon)Department of State Health Services Health Service Region 1 300 Victory Drive PO Box 60968 WTAMU Canyon, TX 79016
Medical Case Manager:Fleta Youngblood, LBSW (CSHCN Contract)
Medical Case Manager:Phyllis McGuire-Dearmon, LMSW
Livingston Office410 East Church, Suite B Livingston, TX 77351
Telephone: 1-936-328-8243 or 1-936-328-8245Fax: 1-936-328-8249
Assistant Director of Social Work Services:Jana Estrada, LMSW
Medical Case Manager:Mona West, LBSW
Lufkin OfficeAngelina County and City Health District 503 Hill Street Lufkin, TX 75904
Telephone: 1-936-632-1250Fax: 1-936-633-0613
Medical Case Manager:Amanda Spencer, LBSW, MSW (CSHCN Contract)
Nacogdoches 2027 North Stallings Drive, Suite B Nacogdoches, TX 75964
Telephone: 1-936-569-5421Fax: 1-936-569-5454
Medical Case Manager:Regina Crain, LBSW
Woodville Office201 Willow Street Woodville, TX 75979
Telephone: 1-409-283-2907Fax: 1-409-283-6071
Medical Case Manager:Mona West, LBSW
TMHP and DSHS Contact Information
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1.2.2.6 Regions 5 South and 6
1.2.2.7 Region 7
Regional Office (Houston)Department of State Health Services/ Public Health Health Service Regions 5 and 6 South 5425 Polk Avenue, Suite J Social Work/CSHCN/MDCP Department Houston, TX 77023-1497
Telephone: 1-713-767-3111Fax: 1-713-767-3125
Director of Social Work Services:Raymond Turner, MA, LMSW-AP
Medical Case Managers:Katherine Spencer, MA, LCSW
Thomas Flores, LMSW
Pamela Golden, LBSW
Calantha Griffin, BSN, MPH, RN
Monita Maxwell, LMSW
Chalandra Robinson, LMSW
Shannon Thurmond, LCSW
Cheronda Wafer, LBSW
Patricia Williams, LBSW
Eligibility and Support:Nancy Benedick
Teresa Figures
Beatriz Garcia
Sandra Kennerson
Janice Sims
Coralyn Taylor
Sickle Cell Coordinator:Linda McDuffie
Beaumont Office785 Liberty Street Beaumont, TX 77701
Telephone: 1-409-951-3091Fax: 1-409-951-3029
Medical Case Managers:Karen Ziegler, BA
Judy Melling, BS, LBSW
Conroe Office608 North Loop East Conroe, TX 77301
Telephone: 1-936-760-4704Fax: 1-936-760-4840
Medical Case Manager:Cathie Richardson, MSW, LCSW
Regional Office (Temple)Department of State Health Services Health Service Region 7 2408 South 37th Street Temple, TX 76504
Telephone: 1-254-778-6744Fax: 1-254-778-4066
Director of Social Work Services:Eileen Walker, MS, LBSW
Medical Case Manager:Lillian Lessenger, LBSW
Eligibility and Support: Alice Watkins
Judith Jackson
Vacant at time of printing
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1.2.2.8 Region 8
Austin Office1601 Rutherford Lane, Building C, Suite C-3 Austin, TX 78754
Telephone: 1-512-873-6300Fax: 1-512-873-6334 or 1-512-873-6345
Case Management Team Leaders:Vacant at time of printing