23.3 Claims InformationIndependent laboratory services must be submitted to TMHP in an approved electronic format or on the CMS-1500 claim form. Providers may purchase CMS-1500 claim forms from the vendor of their choice. TMHP does not supply the forms. When completing a CMS-1500 claim form, all required information must be included on the claim, as information is not keyed from attachments. Superbills, or itemized statements, are not accepted as claim supplements. Laboratory services providers must indicate the specific type of laboratory procedures that are being submitted for claims filing. Refer to: Chapter 36, "TMHP Electronic Data Interchange (EDI)" on page 36-1 for information about electronic claims submissions. Chapter 5, "Claims Filing, Third-Party Resources, and Reimbursement"on page 5-1 for general information about claims filing. Chapter 5, "CMS-1500 Claim Form Instructions"on page 5-21 for instructions on completing paper claims. Blocks that are not referenced are not required for processing by TMHP and may be left blank. |
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Texas Medicaid & Healthcare Partnership CPT only copyright 2008 American Medical Association. All rights reserved. |
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