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News update

Aug 04, 2026

Upcoming PEMS Application Enhancements for Healthcare Providers

The Texas Medicaid & Healthcare Partnership (TMHP) is rolling out upgrades to the Provider Enrollment and Management System (PEMS) starting July 31, 2026. The updates include two new features, SmartTips and WalkMe walkthroughs, designed to make the enrollment process easier and faster for providers by reducing application processing times.

The rollout will happen in phases, starting with applications where providers need to address deficiencies. Full implementation is expected to be completed by the end of 2026.

SmartTips

SmartTips are short, helpful pop-ups that give providers additional information or definitions about specific fields and buttons within PEMS. They appear as question mark icons inside a blue circle, and the information shows up when a user hovers over the icon.

WalkMe Walkthroughs

WalkMe walkthroughs become available after an application has been submitted and deficiencies have been identified. Providers can activate the walkthrough by clicking the Deficiencies Help button located at the top right of the window. The walkthrough then displays step-by-step instructions for correcting each deficiency.

Providers should remember that after fixing all identified deficiencies, they must go to the Agreements page in PEMS to officially submit their updated application.

For more information, providers can call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN (Children with Special Health Care Needs) Services Program Contact Center at 800-568-2413.

Services

Credentialing

Credentialing is the rigorous process of verifying a healthcare provider’s qualifications, including their education, training, licenses, and clinical experience. This service ensures that practitioners meet the high standards required by insurance networks and hospitals to provide care and receive reimbursement.

Billing & Collection

Billing and Collection service involves confirming a patient’s insurance coverage, active status, and specific benefits before their appointment. By identifying co-pays, deductibles, and required prior authorizations upfront, staff can prevent claim denials and help patients understand their financial responsibilities.

Eligibility Verification

Eligibility verification is the process of verifying a patient’s health insurance coverage and benefits to determine what services are covered and the level of coverage available. This process is essential for healthcare providers to ensure that they receive proper reimbursement for services rendered and that patients are not left with unexpected medical bills.

Revenue Cycle Management

RCM is the financial process that manages the entire lifecycle of a patient’s account, from the initial appointment scheduling to the final balance payment. It integrates eligibility, coding, billing, and collections into a single, cohesive workflow aimed at maximizing a practice's profitability.

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