Long-Term Care FFS Claim Processing and Payment Timeline

Apr 14, 2026

1 minute

Long-Term Care FFS Claim Processing and Payment Timeline

The Texas Medicaid & Healthcare Partnership (TMHP) has released a detailed timeline for processing and paying Long-Term Care (LTC) Fee-for-Service (FFS) claims.

The timeline shows each step after a claim is submitted. It helps providers understand how claims move through the system.

Providers can access the timeline under the General Information section on the TMHP LTC Reference Material page or within the 1915(c) Waiver Programs Reference Material section.

For updates on claim and payment processing, including alerts about delays such as holidays or office closures, providers can subscribe to LTC Provider Alerts issued by the Texas Health andHuman Services Commission (HHSC).

For any questions or support, providers can contact the TMHP LTC Help Desk at 800-626-4117.

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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