Denials, appeals and grievances

Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.

appeals grievances

TMHP Adjustments/Appeals — first-level claim appeals address

Official page read

Phone

No phone listed for this route

Published hours

Not published in this record

Product, plan and location

medicaid
Texas

Mailing address

Texas Medicaid & Healthcare Partnership ATTN: Adjustments/Appeals PO Box 200645 Austin, TX 78720-0645

Confirm purpose before mailing

First-level appeals (excluding zero allowed/zero paid) and rejected electronic claims past the 95-day filing deadline.

View source ↗ · Source checked 2026-10-25

Report an update

appeals grievances

HHSC Claims Administrator Operations Management — second-level/administrative appeals

Official page read

Phone

No phone listed for this route

Published hours

Not published in this record

Product, plan and location

medicaid
Texas

Mailing address

Texas Health and Human Services Commission HHSC Claims Administrator Operations Management Mail Code 91X PO BOX 204077 Austin, Texas 78720-4077

Confirm purpose before mailing

Second-level or administrative appeals of fee-for-service claims go to HHSC, not TMHP.

View source ↗ · Source checked 2026-10-25

Report an update

Help the next office

How did your call go?

Share a structured call experience or flag a contact correction. Submissions are reviewed before publication. Patient details, recordings and documents do not belong here.

Share a call experience

Contact you calledWhen you called (your local time)

Minutes until a person answered / you stopped waitingOutcome

Call experienceThis is my call experience. It contains no patient information and may be included in anonymous, moderated statistics. Privacy notice.

Suggest a contact correction

Suggest a correction

Contact to correctWhat needs correcting?Proposed public informationOfficial page that supports the correctionThis is public organization information only. I have not included patient, member, claim or private contact details. Privacy notice.

Call preparation · editorial guide

Make the call count.

Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.

Have ready in your secure workspace

Denial notice, remittance and reason codes
Previous appeal confirmation and decision
Supporting evidence and any required authorization to represent the member

Questions to resolve

Is this a claim correction, provider dispute or member appeal?
What deadline and submission channel apply to this case?
How can the office confirm receipt and track the decision?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

For healthcare offices

Found the contact. Still need to make the call?

Explore how DialClerk organizes the brief, hold time and staff handoff for your next administrative call.

For the people making the calls

Put payer follow-up
on your office’s worklist.

Explore DialClerk for queued calls, hold handling, staff handoffs and a record of the next step. Tell us how your team works.

A request does not create an account or start a call. Use business contact information only. No patient information.