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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:
• 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
For claims submitted on paper, the EOB can be attached.
Refer to: Claims Information section at the end of each chapter of this manual for more information.
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