TMPPM 2009 > Provider Information > Claims Filing > Other Insurance Claims Filing

   
 

5.11 Other Insurance Claims Filing

The following information must be provided in the "Other Insurance" field on the paper claim and in the appropriate field of electronic claims. On the CMS-1500, Fields 9 or 11, and 29 must contain the appropriate information:

Name of the other insurance resource

Address of the other insurance resource

Policy number and group number

Policyholder

Effective date if available

Date of disposition by other insurance resource (used to calculate filing deadline)

Payment or specific denial information


Texas Medicaid & Healthcare Partnership
CPT only copyright 2008 American Medical Association. All rights reserved.
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