5.1 TMHP Claims Information5.1.1 Claims Processed by TMHPCOMPASS21 (C21) is the claims and encounters processing system currently used by the Texas Medicaid & Healthcare Partnership (TMHP) to process Children with Special Healthcare Needs (CSHCN) Services Program claims. COMPASS21 is an advanced Medicaid Management Information System (MMIS) that incorporates the latest claims processing methods and offers access to data and flexibility for future program changes. There are two ways to submit claims to COMPASS21. Providers can submit claims to TMHP through TexMedConnect or a third party vendor. Electronic filing is the most efficient and effective way to submit claims. TMHP also accepts paper claims. Providers that file paper claims are encouraged to switch to electronic submission. Refer to: Chapter 36, "TMHP Electronic Data Interchange (EDI)". A listing of the providers and services that are paid by TMHP can be found in Chapter 3, "Client Benefits and Eligibility" of this manual. All claims sent by mail to TMHP for the first time must be addressed to:
Texas Medicaid & Healthcare Partnership Claim corrections and appeals sent by mail to TMHP must be addressed to:
Texas Medicaid & Healthcare Partnership All other correspondence sent by mail must be directed to a specific department or individual at the following address:
Texas Medicaid & Healthcare Partnership Clients may call TMHP at 1-877-888-2350, which is available Monday through Friday, from 7 a.m. to 7 p.m., Central Time, to obtain information about how to submit drug copay, transportation of remains, and Insurance Premium Payment Assistance (IPPA) reimbursement for premiums. Clients may also call the TMHP-IPPA toll-free client help line at 1-800-440-0493, which is available Monday through Friday, from 7 a.m. to 7 p.m., Central Time, for information about IPPA. |
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Texas Medicaid & Healthcare Partnership CPT only copyright 2008 American Medical Association. All rights reserved. |
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