CSHCN 2009 > Claims Filing, Third-Party Resources, and Reimbursement > Third-Party Resource (TPR)

   
 

5.2.3 Claims Filing Involving a TPR

When a CSHCN Services Program client has other health insurance, that resource must be billed before billing the program. All claims for clients with other insurance coverage must reference the following information whether or not a copy of the EOB from the insurance company is attached:

Name of the other insurance resource

Address of the other insurance resource

Policy (identification) number and group number

Policyholder

Effective date, if available

Date of disposition by other insurance resource

Payment or specific denial information

Refer to: Claims Information section at the end of each chapter of this manual for more information.


Texas Medicaid & Healthcare Partnership
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