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May 2013 CSHCN Services Program Provider Manual

5 Claims Filing, Third-Party Resources, and Reimbursement : Claims Filing Instructions

5.7 Claims Filing Instructions
Providers must read the instructions in this section carefully and supply all the requested information on the claim form.
Claims must contain the billing provider’s complete name, address, provider identifier, and signature of the provider or an authorized representative, or a “signature on file” statement. Claims prepared by computer billing services may have “Signature on File” printed in the signature block if the billing service retains a letter on file from the provider authorizing the service. A claim without the provider’s complete name, address, provider identifier, signature, or “signature on file” statement cannot be processed. The Patient Protection and Affordable Care Act (PPACA) mandates that all claims submitted to TMHP must be filed in accordance with NCCI guidelines. The guidelines can be found in the NCCI Policy and Medicare Claims Processing Manuals, which are available on the CMS website.

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