Texas LTCMI Services for Nursing Facilities
In Texas, no LTCMI means no Medicaid payment. We complete the submissions, chase medical necessity to a determination, and clear the rejections that quietly hold up your census revenue.
Where Texas Facilities Lose Medicaid Revenue
The LTCMI is the Texas-specific section of the MDS, submitted through the TMHP LTC Online Portal. It cannot be entered until the federal MDS 3.0 assessment has gone to CMS and been extracted to the portal, which usually takes 24 to 48 hours. That dependency is where most of the trouble starts.
Form 3618 has to be filed when the facility learns a Medicaid application has been submitted, and Form 3619 governs Medicare co-insurance admissions and discharges — the LTCMI cannot go in ahead of the 3619 admission. If the resident's name, Medicaid ID, or Social Security number does not match between the form and the assessment, TMHP cannot retrieve the assessment at all, and nothing moves until someone notices and corrects it.
Then there is medical necessity. TMHP nurses review the LTCMI to make a determination. If medical necessity is not approved, the Medicaid caseworker is notified and the application is denied. There is a window to submit additional information for reconsideration, but it closes — and it closes quietly, on a portal screen nobody is watching during a staffing shortage.
What Our Texas LTCMI Services Include
We handle the portal submissions and follow-up remotely, or support your business office with the parts they never get to — status monitoring, rejections, and medical necessity follow-up.
- Form 3618 — Resident Transaction Notice — admissions from private pay, admissions to full Medicaid, discharges, and transaction date corrections
- Form 3619 — Medicare/SNF Patient Transaction Notice — co-insurance admissions and discharges, sequenced so the LTCMI is not blocked
- LTCMI completion and submission — entered on the LTC Online Portal as soon as the assessment is available
- Form status monitoring — we watch the portal and act on requests for additional information instead of finding them late
- Medical necessity tracking — pending, denied, and doctor-review statuses followed to a determination, with additional information submitted inside the response window
- LTCMI rejection research — rejections diagnosed, corrected, and resubmitted
- Demographic mismatch correction — name, Medicaid ID, and SSN conflicts resolved so TMHP can retrieve the assessment
- MESAV review and reconciliation — eligibility and service authorization checked against what you are actually billing
- Medicaid-pending account tracking — the application, the LTCMI, and the receivable tracked together instead of in three places
- MDS coordination — the assessment side kept in sequence with the portal side
Forms and Processes We Cover
Texas Medicaid has its own paperwork on top of the federal MDS. This is the part we handle.
| Form or Process | What We Cover |
|---|---|
| Form 3618 | Resident Transaction Notice — admission from private pay, admission to full Medicaid, discharge, and correction of transaction dates |
| Form 3619 | Medicare/SNF Patient Transaction Notice — co-insurance admission and discharge, and LTCMI sequencing behind it |
| LTCMI | Completion, submission, rejection resolution, and correction on the LTC Online Portal |
| Medical necessity (MN) | Status monitoring, additional information submitted within the reconsideration window, doctor review follow-up |
| MESAV | Eligibility and service authorization verification reconciled against billing |
| Medicaid pending | Application follow-up alongside the assessment and receivable |
What Makes NHBS Different
What Changes When This Is Handled Properly
We do not publish recovery figures we cannot tie to a specific facility. What changes is more concrete than a statistic:
Nothing sits unnoticed
Pending, rejected, and information-requested statuses get worked on a schedule instead of when someone happens to log in.
Medical necessity gets a real answer
Denials get additional information inside the window rather than becoming a denied application by default.
The A/R matches the portal
Medicaid-pending balances reconcile to what is actually happening on TMHP, so you know which receivables are real.
Texas LTCMI FAQs
What exactly is the LTCMI?
The Long-Term Care Medicaid Information section is the Texas-specific portion of the MDS assessment. Texas nursing facilities submit it through the TMHP LTC Online Portal, and it is what triggers the medical necessity determination required for Medicaid payment.
Why can't we submit the LTCMI immediately?
Because it depends on the federal assessment. The MDS 3.0 has to be submitted to CMS first, and TMHP then extracts it to the LTC Online Portal — generally 24 to 48 hours later. Only then can the LTCMI section be completed.
There is a second dependency: for a resident moving from Medicare to Medicaid, the LTCMI cannot be submitted before the 3619 admission.
What happens if medical necessity is denied?
The Medicaid caseworker is notified and the application is denied. The provider has a window — 21 calendar days under current TMHP guidance — to supply additional information for further consideration, either by phone or through the portal's Add Note feature.
Missing that window is one of the more expensive and most preventable losses in Texas long-term care billing.
How quickly does Form 3618 need to be filed?
Texas guidance directs facilities to submit Form 3618 as soon as they become aware that a Medicaid application has been filed, and within 72 hours of admission for a resident who already has full Medicaid. Timeliness rules change, so we work from current TMHP guidance rather than memory.
How do you work with our business office?
Remotely, in whatever split works for you. Some facilities give us portal access and hand over the workflow entirely; others keep submissions in-house and use us for status monitoring, rejections, and medical necessity follow-up. Either way the work is handled off-site through the LTC Online Portal.
We are not in Texas. Do we need this?
No. The LTCMI is specific to Texas Medicaid. If you operate outside Texas, the relevant service is MDS consulting, plus whatever your state requires for case-mix. If you operate in both Texas and other states, we can cover both.
MDS and LTCMI Work in Sequence
For Texas nursing facilities these are not two separate projects. The LTCMI can only be entered after the federal MDS 3.0 assessment has gone to CMS and been extracted to the TMHP LTC Online Portal — typically 24 to 48 hours later. When one side slips, the other stalls.
Start With Your Pending and Rejected Queue
Send us what is sitting on the portal. We will tell you what is recoverable, what needs correction, and what is genuinely stuck.