8.3 Claims InformationAPRN services must be submitted to TMHP in an approved electronic format or on the CMS-1500 paper claim form. Providers may purchase CMS-1500 paper claim forms from the vendor of their choice. TMHP does not supply the forms. When completing a CMS-1500 paper claim form, all required information must be included on the claim, as TMHP does not key any information from claim attachments. Superbills, or itemized statements, are not accepted as claim supplements. Refer to: Chapter 37, "TMHP Electronic Data Interchange (EDI)" on page 37-1 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. Section 5.7.1.3, "CMS-1500 Paper Claim Form Instructions" 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 2009 American Medical Association. All rights reserved. |
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