[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-213535-en":3,"doc-seo-213535-105":31,"detail-sidebar-cat-0-en-105":96},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},213535,5909890329169,"McQueen","https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc",7,"Healthcare","Medicaid Provider Enrollment Revalidation Flexibilities and Claims Reprocessing","Medicaid providers must complete revalidation every three or five years to maintain active enrollment, with temporary flexibilities during specified dates. Enrollment gaps are addressed by retroactively backdating enrollment periods up to 365 days for certain disenrolled providers, enabling submission of claims for services within that window. Providers with revalidation dates from mid-December 2024 to May 31, 2025 receive an additional 180 calendar days to complete revalidation in PEMS. Providers should keep submitting claims as services are delivered and contact El Paso Health for help if claims were denied due to untimely revalidation.","Medicaid providers must complete revalida􀆟on every three or five years depending on their specialty, to maintain ac􀆟ve enrollment status. This is a standard procedure, but due to certain issues, flexibili􀆟es have been granted during the specified dates.  \nKEY POINTS ON MEDICAID PROVIDER ENROLLMENT FLEXIBILITIES:  \n•  Enrollment Gaps Closed for Certain Providers: Closure of Enrollment Gaps: If a provider was disenrolled for untimely revalidation between November 1, 2023, and December 12, 2024, the provider’s enrollment period will be retroactively backdated up to 365 days. This means those providers can still submit claims for services rendered during this period.  \n•  Extended Revalidation Period: Providers whose Medicaid revalidation date falls between December 13, 2024, and May 31, 2025, will be given an additional 180 calendar days to complete the revalidation process in the Provider Enrollment and Management System (PEMS).  \nIMPORTANT REMINDER FOR PROVIDERS: DEADLINE FOR REPROCESSING CLAIMS WILL BE JUNE  \n STAR  CHIP  STAR+PLUS  \nValued Providers  \nEl Paso Health  \n3/07/2025  \nMedicaid Provider Enrollment Revalida􀆟on Flexibili􀆟es and Claims Reprocessing  \n30, 2025.  \n• Submit Claims as Services Are Provided: Providers should continue to submit claims to El Paso Health as services are provided. Even if there have been enrollment gaps, do not hold claims. Claims should be submitted as usual to avoid further delays in reimbursement.  \n•  Contact El Paso Health If Claims Were Denied: If your claims were denied due to untimely enrollment revalidation between November 1, 2023, and December 12, 2024, and you have not yet contacted our Provider Relations Department, do so immediately. They can help you navigate the issue and resolve the denial.  \n•  Begin the Revalidation Process Promptly: If you haven’t started the revalidation process yet, you should begin as soon as possible to avoid any disruptions in your Medicaid enrollment status. Given the extended timelines for some providers, this is an excellent opportunity to ensure everything is up to date.  \nEPHP10652503  \nNEXT STEPS FOR PROVIDERS  \n• Stay updated on any additional announcements or updates provided by HHSC, TMHP ANDEPH regarding the revalidation process and flexibilities available to providers.  \n• Providers who have not already done so should take the necessary steps to complete therevalidation process through PEMS.  \n• Providers should submit claims without delay and keep track of any claims that may need reprocessing due to enrollment gaps.  \nBy following these steps, providers can navigate the revalida􀆟on process more efficiently, avoid unnecessary claim denials, and ensure con􀆟nued reimbursement for services provided to Medicaid members.  \nIf you have any ques􀆟ons regarding this communica􀆟on please contact our Provider Rela􀆟onsteam at 915-532-3778 or email us at ProviderRela􀆟onsDG@elpasohealth.com.","cbCaim0VDflyYnfd","https://ap.wps.com/l/cbCaim0VDflyYnfd","pdf",327153,3,1,2,"English","en",105,"# Medicaid Provider Enrollment Flexibilities\n## Enrollment gap closure and retroactive backdating\n## Extended revalidation period via PEMS\n# Provider reminders and next steps\n## Claims submission guidance and denied-claim support\n## Contact and process timing","[{\"question\":\"What flexibilities apply to Medicaid providers with untimely revalidation between November 1, 2023 and December 12, 2024?\",\"answer\":\"For certain providers disenrolled during that window, the enrollment period is retroactively backdated up to 365 days, allowing claims for services rendered during the period.\"},{\"question\":\"How long do providers get if their Medicaid revalidation date falls between December 13, 2024 and May 31, 2025?\",\"answer\":\"Those providers receive an additional 180 calendar days to complete revalidation in the Provider Enrollment and Management System (PEMS).\"},{\"question\":\"What should providers do regarding claims during enrollment gaps or extended timelines?\",\"answer\":\"Continue submitting claims as services are provided and do not hold claims. If claims were denied due to untimely revalidation and providers have not contacted Provider Relations, contact El Paso Health for assistance and follow the revalidation steps in PEMS promptly.\"}]","Medicaid Provider Enrollment Revalidation Flexibilities and Claims Reprocessing | PDF",1788762555,5,{"code":4,"msg":32,"data":33},"ok",{"site_id":25,"language":24,"slug":34,"title":13,"keywords":35,"description":14,"schema_data":36,"social_meta":91,"head_meta":93,"extra_data":95,"updated_unix":29},"medicaid-provider-enrollment-revalidation-flexibilities-and-claims-reprocessing","",{"@graph":37,"@context":90},[38,53,73],{"@type":39,"itemListElement":40},"BreadcrumbList",[41,45,48,50],{"item":42,"name":43,"@type":44,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":46,"name":47,"@type":44,"position":22},"https://docshare.wps.com/document/","Document",{"item":49,"name":12,"@type":44,"position":20},"https://docshare.wps.com/document/healthcare/",{"item":51,"name":13,"@type":44,"position":52},"https://docshare.wps.com/document/medicaid-provider-enrollment-revalidation-flexibilities-and-claims-reprocessing/213535/",4,{"url":51,"name":13,"@type":54,"image":55,"author":60,"headline":13,"publisher":62,"fileFormat":65,"inLanguage":24,"description":14,"dateModified":66,"datePublished":67,"encodingFormat":65,"isAccessibleForFree":68,"interactionStatistic":69},"DigitalDocument",{"url":56,"@type":57,"width":58,"height":59},"https://docshare.wps.com/thumbnails/medicaid-provider-enrollment-revalidation-flexibilities-and-claims-reprocessing/213535.png","ImageObject",300,407,{"name":9,"@type":61},"Person",{"url":42,"name":63,"@type":64},"DocShare","Organization","application/pdf","2026-09-11","2026-09-07",true,{"@type":70,"interactionType":71,"userInteractionCount":20},"InteractionCounter",{"@type":72},"ViewAction",{"@type":74,"mainEntity":75},"FAQPage",[76,82,86],{"name":77,"@type":78,"acceptedAnswer":79},"What flexibilities apply to Medicaid providers with untimely revalidation between November 1, 2023 and December 12, 2024?","Question",{"text":80,"@type":81},"For certain providers disenrolled during that window, the enrollment period is retroactively backdated up to 365 days, allowing claims for services rendered during the period.","Answer",{"name":83,"@type":78,"acceptedAnswer":84},"How long do providers get if their Medicaid revalidation date falls between December 13, 2024 and May 31, 2025?",{"text":85,"@type":81},"Those providers receive an additional 180 calendar days to complete revalidation in the Provider Enrollment and Management System (PEMS).",{"name":87,"@type":78,"acceptedAnswer":88},"What should providers do regarding claims during enrollment gaps or extended timelines?",{"text":89,"@type":81},"Continue submitting claims as services are provided and do not hold claims. If claims were denied due to untimely revalidation and providers have not contacted Provider Relations, contact El Paso Health for assistance and follow the revalidation steps in PEMS promptly.","https://schema.org",{"og:url":51,"og:type":92,"og:title":13,"og:site_name":63,"og:description":14},"article",{"robots":94,"canonical":51},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":97},[98,102,106,110,114,119,122,127,132,135,139],{"id":21,"doc_module":4,"doc_module_name":47,"category_name":99,"show_sort_weight":100,"slug":101},"Story & Novel",90,"story-novel",{"id":22,"doc_module":4,"doc_module_name":47,"category_name":103,"show_sort_weight":104,"slug":105},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":47,"category_name":107,"show_sort_weight":108,"slug":109},"Exam",70,"exam",{"id":30,"doc_module":4,"doc_module_name":47,"category_name":111,"show_sort_weight":112,"slug":113},"Comic",60,"comic",{"id":115,"doc_module":4,"doc_module_name":47,"category_name":116,"show_sort_weight":117,"slug":118},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":47,"category_name":12,"show_sort_weight":120,"slug":121},40,"healthcare",{"id":123,"doc_module":4,"doc_module_name":47,"category_name":124,"show_sort_weight":125,"slug":126},8,"Research & Report",30,"research-report",{"id":128,"doc_module":4,"doc_module_name":47,"category_name":129,"show_sort_weight":130,"slug":131},9,"Religion & Spirituality",20,"religion-spirituality",{"id":130,"doc_module":4,"doc_module_name":47,"category_name":133,"show_sort_weight":130,"slug":134},"World Cup","world-cup",{"id":136,"doc_module":4,"doc_module_name":47,"category_name":137,"show_sort_weight":136,"slug":138},10,"Lifestyle","lifestyle",{"id":140,"doc_module":4,"doc_module_name":47,"category_name":141,"show_sort_weight":30,"slug":142},19,"General","general"]