Identifiers Tab

(FOR LOCAL CMBHS ADMINISTRATORS)

• Provider Identifiers are numbers associated with state licensure, certification, Tax ID number, funding sources or other business functions. Not all business entities have identifiers nor do they need to document them.
• If your business entity is required as a condition of its contract with Texas Department of State Health Services (DSHS) to have an Identifier, such as a Tax ID number or a state license, document that identifier under this tab.
• NOTE: If you have questions about the Identifiers that you are required to required to document in CMBHS, contact your DSHS Contract Manager or the CMBHS HelpDesk.

IDENTIFIER DATA FIELDS

Identifier Type

• Select one identifier type from the list.

Identifier Text (Required for all business entities/provider types)

• Document the identifier information based on the Identifier Type you selected.
• You may use numbers, letters and special characters as needed.

Begin Date: (Required for all business entities/provider types)

• This date may be a begin date for a licensure number, Medicaid provider number or it may represent a contract date with a payer etc.
• TYPE in the 8 numbers of the date in mmddyyyy format. CMBHS will format the numbers into a date.

End Date: (Required for all business entities/provider types)

• Enter date in mmddyyyy format. CMBHS will format the numbers into a date.
• After you TYPE in all the Identifier information, CLICK on Add;
• You may enter one or more Identifiers as appropriate.

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