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May 2013 CSHCN Services Program Provider Manual

5 Claims Filing, Third-Party Resources, and Reimbursement : Third-Party Resource (TPR) : CSHCN Services Program Eligibility Form

5.2.2 CSHCN Services Program Eligibility Form
Insurance coverage is indicated by the word “Insurance” below the date of birth in the CSHCN Services Program Eligibility forms case number block. Refer to Section 3.3.2, “CSHCN Services Program Eligibility Form Sample,” on page 3‑10 for a sample copy of the form. The information is obtained at the time of the application and must be verified at the time services are rendered.
If a provider is aware that a client has other health insurance but the word “Insurance” is not displayed on the CSHCN Services Program Eligibility Form, the provider must notify TMHP of the details concerning the type of policy and scope of benefits.
To report other insurance information, providers can call the TMHP Third-Party Resource (TPR) Unit at 1-800-846-7307, which is available Monday through Friday, from 7 a.m. to 7 p.m., Central Time for additional information or write to the following address:
TMHP TPR Unit
PO Box 202948
Austin, TX 78720-2948

Texas Medicaid & Healthcare Partnership
CPT only copyright 2012 American Medical Association. All rights reserved.