Index

Index

A - B - C - D - E - F - G - H - I - J - L - M - N - O - P - Q - R - S - T - U - V - W - X - Z

Abatacept (Orencia)

Abortion services, family planning funding not used for

DFPS Abuse Hotline

requirements for

staff training on

Abuse and fraud policy

Accessories, durable medical equipment (DME) (home health)

resources and refunds

Acronym dictionary

Add date for client eligibility

Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form

see Chemical dependency

appeals/adjustments

CPT coding manual

Department of Assistive and Rehabilitative Services (DARS), Blind Services

Claims Administrator Contract Management

Limited Program

Medical and UR Appeals

Office of Inspector General (OIG) 1 2

Third Party Resources Unit

Presumptive Eligibility Program

Provider Enrollment

Texas Medical Board registration department 1 2

appeals of incomplete claims

first time claims

HHSC written communication

Inquiry Control Unit

Special Medical Prior Authorization

Third Party Resources Unit

cervical cancer

communicable disease reporting

hyperlipidemia, screening for

Adoption agencies

Advance directives

Advanced practice nurse (APN)

benefits and limitations

Aerosol treatment

After-hours charges

ambulance night calls

Alatrofloxacin mesylate (Trovan)

chemical dependency 1 2

Alcohol (chemical dependency) 1 2

Aliens, undocumented, legalized, family planning services for

allergy injections

allergy services

Allergy immunotherapy

Allergy services

allergy injections

after-hours charges

benefits and limitations

claim form example 1 2

Medicare disposition

membership fees, subscription program

prior authorization process

transport prior authorization

nonemergency services

prior authorization

emergency out-of-state transport

retroactive eligibility

types, definitions

reimbursement 1 2

relation to time of death

air or specialized vehicle

multiple client

nursing facility

to or from state institutions

wait time billing

Ambulatory blood pressure monitoring

Ambulatory electroencephalogram (A/EEG)

benefits and limitations

Ambulatory surgical center

Ambulatory surgical center (ASC)

benefits and limitations

claim form example

claim form example (hospital-based)

National Drug Codes (NDC)

dental services

administered by surgeon

claim form example

for labor and delivery

for sterilization

gynecological examinations

multiple procedures

pain management

intrathecal morphine pumps

physician services

provided by the surgeon

medical direction

monitored anesthesia care

prior authorization requirements

reimbursement methodology

services incidental to surgery and/or anesthesia

Annual exams, family planning

Antibiotics and steroids

Antihemophilic factor

Antispasmodic drugs

see dolasetron mesylate (Anzemet)

administrative claim appeals

AIS appeals guide

allowed AIS appeals

advantages of electronic appeal submission

allowed electronic appeals

disallowed electronic appeals

electronic submission

family planning

disallowed appeals

complaints to HHSC fee-for-service

exception to the 120-day appeal deadline

exception to the 95-day filing deadline

fee-for-service

submitted incorrectly

telephone appeals

administrative claim

cost report settlement

fee-for-service DRG adjustments appeal

utilization review (UR)

continued stay denials

medical necessity 1 2

technical denials

Assays for the diagnosis of vaginitis

Audiological aervices

reimbursement, hearing aid and audiological services

Audiological services

School Health and Related Services (SHARS)

Auditory brainstem implant (ABI)

Augmentative communication device (ACD) system

noncovered items

prior authorization

Authorization for Use and Release of Health Information form

Authorization requirements

CT, CTA, MRI, and MRA

electrodiagnostic (EDX) testing

Automated Inquiry System

Bacillus Calmette-Guérin (BCG)

for treatment of bladder cancer

vaccine for intravesical

vaccine for transvesical

Bariatric surgery

prior authorization requirements

battery charger

Behavioral health services

outpatient, prior authorization for 1 2

Benefits and limitations

clinician-directed care coordination services (CCP)

occupational therapy

personal care services

private duty nursing

radiological and physiological laboratory and portable X-ray supplier

School Health and Related Services (SHARS)

Bilevel positive airway pressure system

with backup (such as BiPAP ST)

without backup (such as BiPAP S)

Billing clients

Birthing center

benefits and limitations

claim form example

national drug codes (NDC)

laboratory services

Medicaid Managed Care enrollment

reimbursement 1 2

Blepharoplasty procedures

Blind Children's Vocational Discovery and Development Program

benefits and limitations

claim form example

claims filing resources

claims information

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Blood counts 1 2

Blood pressure devices 1 2

cholesterol 1 2

hemoglobin type

Blood transfusions

Bone marrow aspiration

Botulinum toxin type A

Brachytherapy, radiation therapy

benefits and limitations

Breast cancer screening

prognostic breast cancer studies

Breast imaging studies

Breast reconstruction

bladder cancer, Bacillus Calmette-Guérin (BCG) for treatment

breast cancer screening

colorectal cancer screening

sigmoidoscopies

colorectal cancer testing

hereditary nonpolyposis colorectal cancer (HNPCC)

physician services

Prognostic breast and gynecological cancer studies

Canes, crutches, walkers

Cardiac blood pool imaging 1 2

benefits and limitations

Cardiopulmonary resuscitaiton (CPR)

Cardiorespiratory monitor

Case Management for Children and Pregnant Women (CPW) 1 2

assistance with claims concerns

assistance with program concerns

benefits and limitations

child abuse reporting

claim form example

referral process

reimbursement 1 2 3

STAR and STAR+PLUS Program enrollment

Case Management for Early Childhood Intervention

See Early Childhood Intervention (ECI)

Catheters, impantation

see Comprehensive Care Program

Centers for Medicare & Medicaid Services (CMS)

Certified nurse-midwife (CNM)

benefits and limitations

claims filing 1 2

claim form example

reimbursement 1 2

Certified registered nurse anesthetist (CRNA)

benefits and limitations

claims filing 1 2

claim form example

national drug codes (NDC)

claims management modifers

epidurals, blood patch

interpreting the R&S report

reimbursement 1 2

Certified respiratory care practitioner (CRCP)

benefits and limitations

claim form example

prior authorization

procedure codes

reimbursement 1 2

Cervical cancer screening

Chelating agents

deferoxamine mesylate (Desferal)

edetate calcium disodium

edetate disodium

Chemical dependency

behavioral health services

exceptions to limited status

psychiatric services

reimbursement 1 2

Chemical dependency treatment facility (CDTF)

benefits and limitations 1 2

claims filing 1 2

claim form example

outpatient counseling

reimbursement 1 2

procedure codes

Chest physiotherapy devices

Childhood Lead Poisoning Prevention Program

Children's hospitals

CHIP perinatal program

newborn transfer

client eligibility verification

program benefits

Chiropractic services

benefits and limitations

claim form example

reimbursement 1 2

Circumcisions 1 2

Cladribine (Leustatin)

Claims filing 1 2 3

appeal time limits

authorization for Medicaid HMO clients

banner message R&S example

birthing center

CHIP perinatal newborn transfer

claims filing instructions

diagnosis coding

procedure coding

type of service

Crossover Type 30 claim form (MRAN)

Crossover Type 31 and 50 claim form

deadline exceptions

appeal time limits

exceptions to the 95-day filing deadline

incomplete information

zero paid claims

electronic billing

provider check amounts

electronic claim acceptance

electronic claims

electronic rejections

newborn claim hints

electronic submission

filing a Medicare-adjusted claim

filing a Medicare-denied claim

hearing aid and audiological services

HHSC payment deadline

home health services

hospice clients

medical services

discharged hospice client

not related to terminal illness

attachments to claims

claim form requirements

clients with a designated or primary care provider

CMS-1500 claim form (blank)

CMS-1500 claim form (paper) billing

CMS-1500 electronic billing

CMS-1500 instruction table

Crossover Type 30 (MRAN)

Crossover Type 31 and 50

dental claim form

instruction table

dental filing instructions

claim form (paper) billing

electronic billing

Family Planning 2017 Claim Form (blank)

Family Planning 2017 Claim Form instruction table

group providers

multipage claim forms

newborn clients without Medicaid numbers

patient status codes

filing tips for outpatient claims

prior authorization numbers on claims

provider signature on claims

claim form (blank)

UB-04 CMS-1450 claim form (paper) billing

UB-04 CMS-1450 electronic billing

UB-04 CMS-1450 instruction table

UB-04 CMS-1450 occurrence codes

vision claim form

medical services

Medically Needy Program (MNP)

Medicare primary paper

Medicare/Medicaid deadlines

modifier requirements for TOS assignment

assistant surgery

interpretations

technical components

online radiology prior authorizations

other insurance filing

claims forward to other insurance carriers

prior authorization requests on Medicaid secondary claims

prior authorization requests through the web

processing procedures

payment error rate measurement (PERM)

delivery options

field explanation

radiological and physiological laboratory and portable X-ray supplier

Remittance and Status (R&S) Report

account receivables

backup withholding penalty information

claims in process

paid or denied claims (hospital)

paid or denied claims (physician)

refunds for Managed Care

refunds for Medicaid

sub-owner recoupments

void and stop pay

section explanation

status of claims

resubmission of TMHP EDI rejections

School Health and Related Services (SHARS)

appealing denied claims

billing units based on 15 minutes

billing units based on an hour

Claims filing instructions

ambulance transfers

birthing center

dental claim form

instruction table

home health services

Hysterectomy Acknowledgment Statement

Claims information

family planning

personal care services

private duty nursing

Texas Health Steps (THSteps)

Client billing 1 2

Client eligibility

CHIP perinatal program

deceased individuals

hospital services

Medicaid identification

restricted Medicaid coverage

selection of provider/pharmacy

Medicaid Buy-In Program

Medicaid eligibility verification

Medicaid for breast and cervical cancer

Medicaid Identification

Medicare Part B Crossovers

Medicare/Medicaid

clients without QMB, MQMB status

contract with outside parties

personal care services

telephone appeals

THSteps medical checkup

Women's Health Program (WHP)

Clinical Laboratory Improvement Amendments (CLIA)

comprehensive health center (CHC)

Clinical nurse specialist

benefits and limitations

claim form example

reimbursement 1 2

Clinical pathology consultations

Clinical records

Clinician-directed care coordination services (CCP)

claim form (blank)

electronic billing

instruction table 1 2

see Clinical nurse specialist

Cochlear implant 1 2

auditory brainstem implant (ABI)

aural rehabilitation

authorization requirements

nonrechargeable batteries

post implant speech therapy 1 2

sound processor replacement

diagnosis coding

independent laboratories, pathologists, radiologists

neonatal intensive care codes

place of service (POS) 1 2

precoding paper claims

procedure coding

type of service (TOS)

Colony stimulating factors

Colorectal cancer screening

genetic testing

sigmoidoscopies

Commodity supplemental food program

Communicable disease reporting 1 2

Community health centers (CHC)

Complaints to DSHS - BHO Services

Complete blood count (CBC)

Comprehensive Care Program (CCP)

Comprehensive health center (CHC)

Clinical Laboratory Improvement Amendments (CLIA)

physician services

Comprehensive outpatient rehabilitation facility (CORF) 1 2

THSteps-CCP claims filing

claim form example

Computed tomography angiography (CTA)

benefits and limitations

Computed tomography imaging (CT)

benefits and limitations

Computer-aided detection (CAD)

Confidential information

procedure codes

Continuous glucose monitoring (CGM)

prior authorization requirements

Continuous positive airway pressure (CPAP)

devices, family planning

elective sterilization services

hysteroscopic sterilization services

implantable capsules

Contraction stress test

Contrast materials

benefits and limitations

see Comprehensive Outpatient Rehabilitation Facility (CORF)

Corneal topography

Corrective shoes

Counseling services

School Health and Related Services (SHARS)

see Case Management for Children and Pregnant Women

Cranial molding orthotics

Craniostenosis (protective) helmets

Crime Victims' Compensation Program

Medically Needy Program

see Vitamin B12 (Cyanocobalamin)

Cytogenetics testing for leukemia and lymphoma

Cytopathology studies

other than gynecological

Darbepoetin alfa

Date of service (DOS)

see liposomal encapsulated daunorubicin (DaunoXome)

Deferoxamine mesylate (Desferal)

Denileukin diftitox (Ontak)

instruction table

adjunctive general services

benefits and limitations

claims and appeals

claim form (paper) billing

client eligibility

diagnostic services

doctor of dentistry practicing as a limited physician

electronic claim billing

emergency services

clients over 21

First Dental Home

general information

handicapping labiolingual deviation (HLD)

HLD score sheet 1 2

hospitalization

ICF-MR dental services

ICF-MR Dental Services

implant services

informed consent

mandatory prior authorization

Medicaid Managed Care enrollment

medical necessity

oral/maxillofacial surgery

orthodontic procedure codes

orthodontic services

comprehensive treatment

mandatory prior authorization

special orthodontic appliances

transfer of services

treatment plans

periodontal services

preventive services

prosthodontics, removable

provider enrollment

reimbursement 1 2

reporting child abuse or neglect

root canal therapy

services (THSteps)

space maintenance (passive appliance)

supernumerary tooth identification

tests and examinations

therapeutic services

third-party resources

THSteps dental services 1 2

TMHP contact information

tooth identification (TID) and surface identification (SID)

treatment plans

utilization review

Dentist (Doctor of Dentistry)

Department of Assistive and Rehabilitative Services (DARS), Blind Services

contact information

Diabetic supplies/equipment

Diagnosis codes

Diagnosis coding

Diagnosis requirements

radiological and physiological laboratory and portable X-ray supplier

benefits and limitations

Diagnostic tests

claim form example

Disallowed appeals, family planning

see Durable medical equipment

Doctor of dentistry

claim form example

limited physician

claims information 1 2

diagnosis codes

mandatory prior authorization

Medicaid Managed Care enrollment

Donor human milk

Doppler studies

Drug abuse, psychiatric services for

chemotherapeutic

Durable medical equipment (DME)

accessories (home health)

accessories (THSteps-CCP)

adjustments (THSteps-CCP)

benefits and limitations (THSteps-CCP)

blood pressure devices 1 2

claim form example (THSteps-CCP)

cochlear implants

continuous passive motion device

incontinence supplies (THSteps-CCP)

mobility aids coding (THSteps-CCP)

modifications (home health)

modifications (THSteps-CCP)

physician signature (THSteps-CCP)

prior authorization

reimbursement (THSteps-CCP)

rental (THSteps-CCP)

repairs (THSteps-CCP) 1 2

supplier (THSteps-CCP)

supplier policies (THSteps-CCP)

Durable medical equipment (DME) Certification and Receipt Form

Early Childhood Intervention

Early Childhood Intervention (ECI) 1 2

benefits and limitations 1 2

case management

claims filing 1 2 3

claim form example (THSteps-CCP only)

enrollment 1 2 3

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

statutory requirements

Echoencephalography

see Early Childhood Intervention (ECI)

Edetate calcium disodium

Edetate disodium

Education, family planning

see electrodiagnostic (EDX) testing

see Idursulfase (Elaprase)

Elective abortions

required statements for claims

Elective sterilization

Electrical percussor

Electrocardiogram (EKG)

Electrodiagnostic (EDX) testing

authorization requirements

electromyography (EMG)

maximum number of studies

nerve conduction studies (NCS)

Electromyography (EMG)

electrodiagnostic (EDX) testing

Electronic appeal submission, family planning

Electronic blood pressure monitoring device

Electronic claims submission

Electronic Data Interchange

see EDI and TMHP EDI

Electronic data interchange (EDI)

advantages of electronic services

automated maintenance process

electronic billing

electronic services

electronic transmission reports

provider check amounts

supported file types

third party billing agents

third party vendor implementation

Electronic funds transfer

enrollment procedures

medical transportation

refer to type of provider

School Health and Related Services (SHARS)

see also client eligibility

emergency care restrictions

restricted coverage

Emphasis> (TEFRA)

Encounter data, collecting

cystourethroscopy

endoscopic retrograde cholangiopancreatography (ERCP)

lower gastrointestinal endoscopy

sinus endoscopy

upper gastrointestinal endoscopy

advanced practice nurse (APN)

ambulatory surgical center (ASC)

birthing center

Blind Children's Vocational Discovery and Development Program

Case Management for Children and Pregnant Women (CPW)

certified nurse-midwife (CNM)

certified registered nurse anesthetist (CRNA)

certified respiratory care practitioner (CRCP)

chiropractic services

clinical nurse specialist (CNS)

Early Childhood Intervention (ECI)

electronic funds transfer

in-home total parenteral nutrition

licensed clinical social worker (LCSW)

nurse practitioner (NP)

outpatient rehabilitation centers

personal care services

physical therapist

physician assistant (PA)

private duty nursing

psychologist 1 2

radiological and physiological laboratory and portable X-ray supplier

School Health and Related Services (SHARS)

Medicaid managed care

nonschool provider

managed care program

Enteral nutritional products

Enzyme immunoassay

Epidural, implantable infusion pumps

Epoetin alfa (EPO)

see also Texas Health Steps (THSteps)

Erythropoietin alfa (EPO)

Esophageal pH probe monitoring

Exceptions-to-periodicity checkup, Texas Health Steps (THSteps)

External insulin pumps

Extracorporeal membrane oxygenation (ECMO)

Face-to-face services

Familial adenomatous polyposis

Family planning

appealing claims

disallowed appeals

billing for non-family planning services

billing HMOs for out-of-network services

claims information

client contraceptive choice

collecting encounter data

contraceptive devices and related procedures

diagnosis codes

disallowed appeals

dispensing medication

drugs and supplies

electronic appeal submission

electronic Title X claims

filing deadlines

hospital setting/auspices

incomplete sterilization

initial inpatient education

injection administration

laboratory procedures

limited Medicaid coverage

Medicaid Managed Care claims

medical counseling

other office visits

outpatient visits

paper appeal submission

parental consent

physician services

implantable capsules

problem counseling

procedure codes

provider enrollment

provider guidelines

provider requirements

rural health clinic providers

services for undocumented aliens, legalized aliens

consent form and instructions

teen group counseling

third-party insurance

Title X other EDI claims

Title X paper claims

Title X payments

Title XIX enrollment 1 2

Family Planning 2017 Claim Form

Family Planning Services

claim form example

claim form example (APN)

Sterilization Consent Form

Family Planning Services for Hospitals, FQHCs

claim form example

Federal financial participation (FFP)

Federally qualified health center (FQHC)

benefits and limitations

claim form example

claim form example (follow-up)

national drug codes (NDC)

medically necessary services

Medicare-Medicaid crossover claims pricing

newborn eligibility

Ferritin and iron studies

Fetal fibronectin

Filing deadlines

family planning

TPR 110-day rule

Fluocinolone acetonide (Retisert)

Fluoride varnish application

1120 Medical Bills Transmittal

3652A Client Assessment Review and Evaluation (CARE) Form

Abortion Certification Statements Form

Ambulance Fax Cover Sheet

American Dental Association (ADA) claim form

instruction table

Authorization to Release Confidential Information

Birthing Center Report (Form 7484)

Child Abuse Reporting

Child Health History

Claim form examples

Credit Balance Refund Worksheet

Crossover Type 30 claim form (MRAN)

Crossover Type 30 claims

Crossover Type 31 and 50

DME Certification and Receipt Form

Donor Human Milk Request Form

Electronic Funds Transfer (EFT) Authorization Agreement

Electronic Funds Transfer (EFT) Information

Electronic Remittance and Status (ER&S) Agreement 1 2

Electronic Remittance and Status Agreement

Extended Outpatient Psychotherapy/Counseling Request Form

External Insulin Pump

Federally Qualified Health Center Report (Form 7484)

Hearing Evaluation and Fitting and Dispensing Report (Form 3503)

Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form

Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form

Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions

Home Health Services Plan of Care (POC)

Prior Authorization Checklist

Hospital Report (Form 7484)

Hysterectomy Acknowledgment Form

Informational Inquiry Form

Maternal Serum Prenatal Triple Screen 1 2

Medicaid Certificate of Medical Necessity for Chest Physiotherapy Devices

Extended Request

Initial Request

Medicaid Certificate of Medical Necessity for CPAP/BiPAP or Oxygen Therapy

Medicaid Certificate of Medical Necessity for In-Home Total Parenteral Hyperalimentation

Medicaid Certificate of Medical Necessity for Reduction Mammaplasty

Medicaid Identification

Medicaid Identification (Form H3087) 1 2 3

Medicaid verification letter (Form H1027-A)

Medicaid verification letter (Form H1027-B)

Medicaid verification letter (Form H1027-C)

Nursing Addendum to Plan of Care

Other Insurance Form

Behavioral Health Consent Form

Behavioral Health Consent Form (Spanish)

Community Health Services Referral Request Form

Inpatient/Outpatient Authorization Form

Pre-Contractual/Recredentialing Site and Medical Record Evaluation 1 2

Physician's Examination Report

Physician's Medical Necessity Certification for Nonemergency Ambulance Transports

Private Pay Agreement

Provider Information Change Form

Psychiatric Hospital Inpatient Initial Admission Request Form

Psychiatric Inpatient Extended Stay Request Form

Pulse Oximeter Form

Radiology Prior Authorization Request

Refund Information Form

Request for Electronic Funds Transfer

Request for Extension of Outpatient Therapy (Form TP-2)

Request for Initial Outpatient Therapy (Form TP-1)

Sample letter - signature on file

Specimen Submission Form G-1C

Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen

Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen (Spanish)

Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen, Instructions

Statement for Initial Wound Therapy System In-Home Use 1 2

Sterilization Consent Form

Texas Medicaid Palivizumab (Synagis) Prior Authorization Request Form

Texas Medicaid Vendor Drug Program Palivizumab (Synagis) Prescription Form

Child Health Clinical Records

Child Health History

Child Health Record

13 Months-2 Years

Dental Criteria for Dental Therapy Under General Anesthesia

Dental Mandatory Prior Authorization Request

ECI Request for Outpatient Therapy

Form Pb-110, Risk Assessment for Lead Exposure

Hearing Checklist for Parents 1 2

Mental Health Interview Tool/Referral Form

Ages 10-12 Years

Ages 13-20 Years

Mental Health Parent Questionnaire

Ages 10-12 Years

Ages 10-12 Years (Spanish)

Ages 13-20 Years

Ages 13-20 Years (Spanish)

Ages 3-9 Years (Spanish)

Ages Birth-2 Years

Ages Birth-2 Years (Spanish)

PPD Agreement for Texas Health Steps Providers

Prior Authorization Request

Private Duty Nursing 4 or 6 Month Authorization

Referral Form Instructions

Risk Assessment for Lead Exposure

Questionnaire (Spanish)

Screening and Education Tool

Patient Eligibility Screening Record

Patient Eligibility Screening Record (Spanish)

Provider Enrollment

Questions and Answers

THSteps Dental Criteria for Dental Therapy Under General Anesthesia 1 2

Tort Response Form

Triplicate prescription form

Ventilator Service Agreement

Vision Care Eyeglass Patient Certification Form

Wheelchair Seating Evaluation Form

Wound Therapy System In-Home Use

Recertification

Frames, eyeglasses

Fraud and abuse

suspected cases

Fraud and abuse policy

Functional MRI (fMRI)

benefits and limitations

Gamma globulin/immune globulin

Gemcitabine HCI (Gemzar)

see Gemcitabine HCI (Gemzar)

Genetic testing

colorectal cancer screening

benefit schedule

claim form example

genetic evaluation and counseling

reimbursement 1 2

Granisetron hydrochloride

Group clinical visits

Guidelines for tuberculosis skin testing

Gynecological health services

assays for the diagnosis of vaginitis

diagnostic hysteroscopy

elective abortions

examination under anesthesia

Pap smear (cytopathology studies)

surgery for masculinized females

Handicapping labiolingual deviation (HLD)

see Healthcare Common Procedure Coding System (HCPCS)

Health maintenance organization (HMO)

Healthcare Common Procedure Coding System (HCPCS)

Hearing aid and audiological services

hearing aid device

hearing screening

hearing testing

limitations and exclusions

Hearing aid and audiometric evaluations

claim form example

newborn hearing screening

prior authorization

Hearing aid devices

Hearing screening

early hearing detection and intervention

Hearing services, THSteps

Heart transplants 1 2 3

Helicobacter pylori (H. pylori)

Helmets, protective (craniostenosis)

Hematopoietic agents

Hemoglobin type

hepatitis A and B

hepatitis B immune globulin (HBlg)

required screening of pregnant women

hepatitis B immune globulin (HBlg)

Hereditary nonpolyposis colorectal cancer (HNPCC)

central office addresses

payment deadline

complaints and fair hearings

Public Health Region contacts

Public Health Regions map

High-volume providers

model workplace guidelines

Home health services

blood glucose monitors

canceling an prior authorization

change of address/telephone number

claim form example

DME/medical supplies

skilled nursing visit and physical therapy

skilled nursing visits

claims information

national drug code (NDC)

client evaluation

criteria for grouping levels

decubitus care accessories

diabetic supplies/equipment

durable medical equipment (DME)

enteral feeding pumps

group 1 support surfaces

group 2 support surfaces

group 3 support surfaces

home health aide services

home health aide visits

hospital beds and equipment procedure code

incontinence supplies and equipment

insulin and insulin syringes

medical supplies

medication administration limitations

procedure codes and limitations

nursing services

nutritional productions and supplies

occupational therapy

prior authorization procedures

physical therapy services 1 2 3

prior authorization

possible Medicare clients

prior authorization 1 2

prior authorization of retroactive eligibility

professional nursing

prohibition of Medicaid payment

pulsatile jet irrigation wound care system

respiratory equipment and supplies

procedure codes and limitations

retroactive eligibility

sealed suction wound care system

skilled nursing and home health aid services provider responsibilities

skilled nursing and home health aide services assessments and reassessments

skilled nursing and home health aide services not prior authorizated

skilled nursing and home health aide services prior authorization requirements

skilled nursing care

skilled nursing visits

supervision of home health aides

supplies submitted with a plan of care

vocational nursing

written plan of care

Hormone injections

Hospice Program

acknowledgment of penalty notice

cochlear implant

diagnosis related group (DRG)

emergency department services

general information

benefits and limitations

change of ownership

claim form example

claims information

client transfer

newborn services

observation status to inpatient admission

propsective payment methodology (DRG)

psychiatric hospital/facility (THSteps-CCP)

utilization review

lung volume reduction surgery

Medicaid relationship to Medicare

nonemergency ambulance services

nursing facility admission

benefits and limitations

change of ownership

claim form example

claims filing 1 2

day surgery services

observation room services

total parenteral hyperalimentation

utilization review

aerosol treatment

bacillus calmette-Guzin (BCG) vaccine

chemical dependency

colorectal cancer screening

contraction stress test

fetal nonstress testing

Helicobacter pylori

hyperbaric oxygen therapy

hysterectomy services

laboratory services

neuropsychological testing

osteopathic manipulation treatment (OMT)

pentamidine aerosol

psychiatric services 1 2

psychological testing

pulmonary function studies

radiation therapy

radiology services

rehabilitation services

tetanus injections, acute care

Tax Equity and Fiscal Responsibility Act<

third party liability reporting

utilization review appeals

Hospital visits

physician services

Human donor milk

Human Papillomavirus (HPV), vaccination

Human rabies immune globulin (HRIG)

Human rabies vaccine

Hyperalimentation Supplier

claim form example

Hyperbaric oxygen therapy (HBOT), physician services

Hysterectomy 1 2

Acknowledgment Statement

claims filing instructions

Hysterectomy Acknowledgment Form

Hysteroscopic sterilization

Ibutilide fumarate

Idarubicin/Idamycin PFS injection

Idursulfase (Elaprase)

Ilizarov device, physician services

Immune globulin (Cytogam)

general recommendations

hepatitis A and B

hepatitis B 1 2

human papillomavirus (HPV)

human rabies immune globulin (HRIG)

measles, mumps, and rubella (MMR)

neumococcal polysaccharide vaccine

physician services

pneumococcal 7-valent conjugate vaccine

provider reimbursement fee

Recommended Childhood and Adolescent Immunization Schedule

Recommended Childhood Immunization Schedule

Texas Health Steps (THSteps)

Texas Vaccines for Children (TVFC) Program

Vaccine Adverse Event Reporting System (VAERS)

Immunosuppressive drugs

Implantable infusion pumps

In-home total parenteral nutition

supplier enrollment

In-home total parenteral nutrition

benefits and limitations

prior authorization

reimbursement 1 2

supplies claims filing

claim form example

Incomplete sterilization, family planning

procedure codes with limitations

Independent laboratory

benefits and limitations

claim form example

CLIA regulations

electronic filing for laboratory

laboratory services for people on dialysis

physician-performed microscopy procedure certificates

reference labs and lab handling

reimbursement 1 2

repeated procedures

THSteps outpatient laboratory services

transfusion medicine

waiver certificate

Independent practitioners

Indian Health Services

Indian Self-Determination and Education Assistance Act

Infliximab (Remicade)

Influenza vaccine

Injectable contraceptives

abatacept (Orencia)

alatrofloxacin mesylate (Trovan)

allergy injections

antibiotics and steroids

antihemophilic factor

botulinum toxin type A

chelating agents

edeferoxamine mesylate (Desferal)

edetate calcium disodium

edetate disodium

cladribine (Leustatin)

denileukin diftitox (Ontak)

dolasetron mesylate (Anzemet)

fluocinolone acetonide (Retisert)

gamma globulin/immune globulin

gemcitabine HCI (Gemzar)

granisetron hydrochloride

growth hormone 1 2

hematopoietic agents

darbepoetin alfa

epoetin alfa (EPO)

ibutilide fumarate

Idarubicin/Idamycin PFS

Idursulfase (Elaprase)

immunosuppressive drugs

implantable infusion pumps

Infliximab (Remicade)

joint and trigger point

leuprolide acetate (Lupron Depot)

liposomal encapsulated daunorubicin (DaunoXome)

maternal serum alpha-fetoprotein

melphalan hydrochloride

porfimer (Photofrin)

Rho(D) immune globulin

see also Immunizations

Strontium-89 chloride

Thyrotropin alpha for injection (Thyrogen)

Integrated Care Management (ICM) 1 2

client eligibility

spell of illness limitation

Intermediate oral evaluation, THSteps

Intermittent positive-pressure breathing (IPPB) treatment

Internal control number (ICN)

Intestinal transplants

Intralesional injections

Intraocular lenses

Intraoperative MRI (iMRI)

benefits and limitations

Intrathecal infusion, implantable infusion

Intrathecal morphine pumps

intrauterine device (IUD)

Intravitreal drug delivery system

Iridectomy/iridotomy/trabeculectomy

Iron injections

Iron Sucrose (Venofer)

see Intrauterine device

Joint injections

follow-up care guidelines

required tests for medical checkups

newborn screening

screening procedures

see also Independent laboratory

specimen submission

THSteps services

Laboratory procedures, family planning

Laboratory services

clinical lab panel implementation

clinical pathology consultations

see Licensed clinical social worker (LCSW)

lead poisoning prevention educational materials

measuring blood lead levels

Legislative requirements

Leuprolide acetate (Lupron Depot)

see Cladribine (Leustatin)

Levels for custom manual wheelchairs

Licensed clinical social worker (LCSW)

benefits and limitations

claim form example

reimbursement 1 2

Licensed dietitian

THSteps-CCP claim form example

Licensed marriage and family therapist (LMFT)

claim form example

documentation requirements

encounter limit

reimbursement 1 2

Licensed physician assistant

Licensed professional counselor (LPC)

benefits and limitations

claim form example

documentation requirements

encounter limit

reimbursement 1 2

Limitations, Medicaid Program

noncovered procedures

Liposomal encapsulated daunorubicin (DaunoXome)

Liver transplants 1 2

Local health departments contacts

LoneSTAR Select Contracting Program, managed Care

Lung transplants 1 2

Lung volume reduction surgery (LVRS)

see Leuprolide acetate (Lupron Depot)

Magnetic resonance angiography (MRA)

benefits and limitations

Magnetic resonance imaging (MRI)

benefits and limitations

advance directives

after-hours guidelines

claims filing information

client enrollment

client responsibilities

complaints and fair hearings

continuous coverage

cultural competency

Health Insurance Premium Payment (HIPP) Program

health plan changes

primary care provider

eligible provider types

primary care provider changes

prior authorization 1 2

provider-to-client ratio

third party resources

Manual wheelchairs

Maternal and child health

services block grant program

Maternal serum alpha-fetoprotein

Maternity service clinic

claims filing 1 2

claim form example 1 2

classification of risk

documentation requirements

education/counseling

interim history

intial antepartum care visit components

laboratory tests 1 2

physical examination 1 2

postpartum care visit

risk assessment

subsequent antepartum care visits

Measles, mumps, and rubella (MMR) vaccine

Medicaid for breast and cervical cancer, client eligibility

Medicaid Identification

Medicaid Qualified Medicare Beneficiary (MQMB) 1 2

Medicaid relationship to Medicare

Medicaid verification letter

Medicaid, Texas

services provided outside Texas

Medicaid, Texas Program

client eligibility 1 2

fraud and abuse policy

medical necessity, definition

relationship to Medicare

requirements for participation

restricted coverage

verification documents

Medical checkup (THSteps)

birth through 20 years of age

dental referral

submission of specimens

procedures and tests 1 2

verification of

Medical counseling

family planning

Medical nutritional products

Medical transportation

program limitations 1 2

Medically complex

Medically Needy Program (MNP)

closing MNP case

spend down processing

claims deadlines

crossover reimbursement

fraud and abuse policy

Medicare/Medicaid

relationship between

renal dialysis facility

Medication levels

Melphalan hydrochloride

Mental health (MH) mental retardation (MR)

benefits and limitations

mental health rehabilitation

rehabilitative services limitations

service coordination contact codes

STAR Program enrollment

Mental health case management

claim form example

Mental health services, outpatient, prior authorization for

Migrant health centers

Military hospital

benefits and limitations

claim form example (emergency inpatient)

claims information

inpatient services

utilization review

THSteps-CCP DME

Modifications to durable medical equipment (DME) home health

Modifier requirements

radiological and physiological laboratory and portable X-ray supplier

ambulance claims

See Medical transportation

Multidisciplinary care

Muscular Dystrophy Association

Myocardial perfusion imaging 1 2

National Drug Code (NDC) 1 2 3 4

Natural family planning method

Negative pressure ventilators

Nerve conduction studies (NCS)

electrodiagnostic (EDX) testing

blood screening

eligibility process

federally qualified health center

hearing screening

1-3-6 Month Practitioner's Guide

resuscitation 1 2

screening, statutory requirements

THSteps examination

Non-face-to-face

care plan oversight

clinician supervision of a home health client

clinician supervision of a hospice client

medical conferences

prolonged services

Noncoronary percutaneous transluminal angioplasty

Nonprosthetic eyewear

Nonstress testing

NorthSTAR Program

client eligibility

client enrollment

complaints and appeals

guidelines for working with NorthSTAR clients

hospital billing

provider requirements

quality improvement monitoring

see nurse practitioner

Nuclear medicine

see certified nurse midwife, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist

Nurse practitioner

benefits and limitations

claim form example

reimbursement 1 2

Nursing services

School Health and Related Services (SHARS)

Nutritional (enteral) products, supplies, and equipment

Nutritionist, family planning

OB-GYN provider enrollment

Observation 1 2

less than 24 hours

outpatient 1 2 3

Obstetrics/prenatal care

Obtaining palivizumab

Occupational therapists

claim form example (THSteps-CCP)

physician signature

prior authorization

Occupational therapy

School Health and Related Services (SHARS)

Occupational therapy services

Occurrence codes for UB-04 CMS-1450

Office visit with lab and radiology

claim form example

see denileukin diftitox (Ontak)

Ophthalmology 1 2

Oral medications

see Abatacept (Orencia)

transplant services

Orthodontic services

mandatory prior authorization

procedure codes

special orthodontic appliances

Orthotic and prosthetic suppliers

benefits and limitations

claim form example (THSteps-CCP)

physician signature

prior authorization

Osteogenic stimulation 1 2

invasive electrical osteogenic stimulator

noninvasive electrical osteogenic stimulator

prior authorization

professional services

ultrasound osteogenic stimulator

Osteopathic manipulation treatment (OMT)

Out of state medical providers

military hospital physician services

physician services in an outpatient hospital setting

Outpatient facilities

home delivery system types

initial medical necessity certification

recertification

see Program for Amplification for Children of Texas (PACT)

Palivizumab (Synagis)

chemistry tests

complete blood counts

Paper appeal submission, family planning

Parental accompaniment 1 2

statutory requirements

Patient Acknowledgment Statement

Payment error rate measurement (PERM)

access and availability standards

denials and appeals (inpatient)

facility services

professional services (inpatient)

behavioral health services

case management fee

client eligibility

client enrollment

client responsibilities

community health services

complaints and appeals

contact numbers

covered services

behavioral health services

family planning services

OB/GYN services

Texas Health Steps

vision services

credentialing committee

facility/hospital services

linguistic services

monthly member panel report

notification of admission 1 2

scheduled admissions

observation services

office and medical record standards

confidentiality of medical records

medical records audit

provider site requirements

primary care provider

primary care provider selection

services to be provided

verifying assignment

prior authorization

procedures requiring

provider enrollment

provider responsibilities

client self-referred services

referral network

specialist-to-specialist

emergency outpatient services

network hospitals

non-emergency outpatient clinic services

out-of-network hospitals

PCCM claims details

specialists responsibilities

support services

transportation services

see Personal care services

Pediatric hospital cribs

Pediatric nurse practitioner

see nurse practitioner

Pediatric pneumogram

Pentamadine, aerosol

Percutaneous transluminal coronary intervention

Periodicity schedule (THSteps)

birth through 20 years of age

medical checkup

Personal care services

client eligibility

provided in group settings

provider responsibilities

School Health and Related Services (SHARS)

Personal care services (CCP)

eligibility (THSteps-CCP)

triplicate prescription form

claim form example (THSteps-CCP)

Phlebotomy, therapeutic

see Porfimer (Photofrin)

Phototherapy devices

Physical examinations, sports

Physical therapists 1 2 3

claim form example

reimbursement 1 2

claim form example

physician signature

prior authorization

Physical therapy

School Health and Related Services (SHARS)

Physical therapy services

comprehensive health centers (CHC)

dentistry, doctor of

domiciliary, rest home, or custodial care

emergency department services

evaluation and management services

group clinical visits

inpatient hospital services

concurrent care

hospital admissions, initial visits, and subsequent visits

hospital discharge

nursing facility services

intermittent positive-pressure breathing (IPPB)

kidney transplant

office or other outpatient hospital services

consultation services

new and established patient services

observation services

preventive care visits

services outside of business hours

outpatient hospital reimbursement

physician assistant (PA)

prior authorization

procedures and services

see also PCCM, referrals

reimbursement 1 2

aerosol treatment

allergy immunotherapy

allergy testing

direct nasal mucous membrane test

inhalation bronchial challenge testing

ophthalmic mucous membrane test

patch or application tests

percutaneous and intracutaneous skin test

photo or photo patch skin test

RAST/MAST tests

for labor and delivery

for sterilization

for THSteps dental

multiple procedures

pain management

provided by the surgeon

services incidental to surgery and/or anesthesia

assessment of higher cerebral function testing

Bacillus Calmette-Guérin (BCG) for treatment of bladder cancer

bariatric surgery

prior authorization requirements

breast cancer screening

cardiopulmonary resuscitaiton (CPR)

procedure codes

cochlear implant

auditory brainstem implant (ABI)

authorization requirements

equipment and batteries

post implant speech therapy

sound processor replacement

colorectal cancer screening

sigmoidoscopies

colorectal screening

genetic testing

continuous glucose monitoring (CGM)

prior authorization

contraction stress testing

corneal transplants

diagnostic tests

ambulatory blood pressure monitoring

ambulatory electroencephalogram (A/EEG)

bone marrow aspiration

cytopathology studies other than gynecological

echoencephalography

electrocardiogram (EKG)

electrodiagnostic (EDX) testing

esophageal pH probe monitoring

Helicobacter pylori (H. pylori)

myocardial perfusion imaging

pediatric pneumogram

doppler studies

echography scan, opthalmic

cystourethroscopy

endoscopic retrograde cholangiopancreatography (ERCP)

lower gastrointestinal endoscopy

sinus endoscopy

upper gastrointestinal endoscopy

external cephalic version

extracorporeal membrane oxygenation (ECMO)

family planning

elective sterilization services

hysteroscopic sterilization

implantable capsules

gynecological health services

assays for the diagnosis of vaginitis

diagnostic hysteroscopy

elective abortions

examination under anesthesia

surgery for masculinized females

Helicobacter pylori

hepatitis B immune globulin (HBlg)

hospital visits

hyperbaric oxygen therapy (HBOT)

Ilizarov device

hepatitis A and B

human papillomavirus (HPV)

human rabies immune globulin (HRIG)

human rabies vaccine

measles, mumps, and rubella (MMR)

pneumococcal polysaccharide vaccine

Texas Vaccines for Children (TVFC) Program

abatacept (Orencia)

alatrofloxacin mesylate (Trovan)

allergy services

antibiotics and steroids

antihemophilic factor

botulinum toxin type A

chelating agents

deferoxamine mesylate (Desferal)

edetate calcium disodium

edetate disodium

cladribine (Leustatin)

denileukin diftitox (Ontak)

dolasetron mesylate (Anzemet)

fluocinolone acetonide (Retisert)

gamma globulin/immune globulin

gemcitabine HCI (Gemzar)

granisetron hydrochloride

hematopoietic agents

darbepoetin alfa

epoetin alfa (EPO)

ibutilide fumarate

Idarubicin/Idamycin PFS

Idursulfase (Elaprase)

immunosuppressive drugs

implantable infusion pumps

Infliximab (Remicade)

joint and trigger point

leuprolide acetate (Lupron Depot)

melphalan hydrochloride

porfimer (Photofrin)

Rho(D) immune globulin

Strontium-89 chloride

Thyrotropin alpha for injection (Thyrogen)

intraocular lenses

clinical lab panel implementation

clinical pathology consultations

long term care nursing facility

magnetic resonance angiography (MRA)

magnetic resonance imaging (MRI)

mastectomy and breast reconstruction

neuromuscular electrical stimulation (NMES)

neuropsychological testing

neurostimulators

doral column neurostimulator (DCN)

intracranial neurostimulators (ICN)

NMES and TENS supplies

NMES/TENS garments

percutaneous electrical nerve stimulators (PENS)

prior authorization

sacral nerve stimulators (SNS)

transcutaneous electrical nerve stimulators (TENS)

hearing screening

noninvasive diagnostic studies

nonstress testing

nuclear medicine

obstetrics/prenatal care

occupational therapy

ophthalmology 1 2

oral medications

orthognathic surgery

pelvic ultrasound

physical therapy 1 2

polysomnography

psychological testing

radiation therapy

reduction mammoplasties

speech-language therapy

stereotactic radiosurgery

transplant prior authorization

pneumococcal 7-valent conjugate vaccine

vaccinationsee Immunizations

vagal nerve stimulators (VNS)

ventilation assist and management

sign language interpreting services

substitute physician

direct supervision

personal supervision

teaching attending physician and resident physician

supplies, trays, and drugs

wearable cardiac defibrillator

Physician assistant (PA)

benefits and limitations

National Drug Code (NDC)

reimbursement 1 2

Physician services

School Health and Related Services (SHARS)

Physiological laboratory

Pneumococcal 7-valent conjugate vaccine

Pneumococcal polysaccharide vaccine

Podiatrist services

clubfoot casting

echography/ultrasound of extremity

flat foot treatment

in a nursing facility

routine foot care

vascular studies

Polysomnography

Porfimer (Photofrin)

Portable X-ray supplier

Positron-emission tomography (PET)

benefits and limitations

post-exposure prophylaxis (PEP)

Power wheelchairs

Preadmission Screening and Annual Resident Review (PASARR)

Preferred Provider Organization (PPO)

Premature infants

obstetrics and prenatal care

Prescriptions, delivery

Primary care provider

see Managed care

Prior authorization

nonemergency retroactive eligibility

certified nurse-midwife (CNM)

certified respiratory care practitioner

clinician-directed care coordination services (CCP)

continuous glucose monitoring (CGM)

durable medical equipment supplier

Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form 1 2

Ambulance Fax Cover Sheet

Donor Human Milk Request Form

Extended Outpatient Psychotherapy/Counseling Request Form

External Insulin Pump

Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form

Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions

Home Health Services Plan of Care (POC)

Home Health Services Plan of Care (POC) Instructions

Home Health Services Prior Authorization Checklist

Medicaid Certificate of Medical Necessity for Chest Physiotherapy Devices

Extended Request

Initial Request

Medicaid Certificate of Medical Necessity for CPAP/BiPAP or Oxygen Therapy

Medicaid Certificate of Medical Necessity for Reduction Mammaplasty

Medical Necessity for In-Home Total Parenteral Hyperalimentation

Inpatient/Outpatient Authorization Form

Physician's Medical Necessity Certification for Nonemergency Ambulance Transports

Psychiatric Hospital Inpatient Initial Admission Request Form

Psychiatric Inpatient Extended Stay Request Form

Pulse Oximeter Form

Radiology Prior Authorization Request Form

Request for Extension of Outpatient Therapy (Form TP-2)

Request for Initial Outpatient Therapy (Form TP-1)

ECI Request for Outpatient Therapy

THSteps Dental Mandatory Prior Authorization Request Form

THSteps-CCP Prior Authorization Private Duty Nursing 4 or 6 Month Authorization

THSteps-CCP Prior Authorization Request Form

home health services

in-home total parenteral nutrition

licensed dieticians

mandatory prior authorization (dental)

occupational therapists

orthodontic services

orthotic and prosthetic suppliers

outpatient behavioral health services 1 2

outpatient mental health services

PCCM outpatient prior authorization

personal care services

physical therapists

private duty nursing

programmable pumps

psychological testing

RSV prophylaxis

speech-language pathologists

telephone numbers

THSteps and ICF-MR dental prior authorization

THSteps benefits

THSteps-CCP numbers for

tissue transplant services

transport, emergency out-of-state

Prior authorization numbers

Private duty nursing (THSteps-CCP)

claim form example

client eligibility

Procedure codes

HCPCS codes (level II)

levels of codes

tuberculosis 1 2

DOT/DOPT examination

follow-up examination

initial examination

monthly examination

Professional providers

Prognostic breast and gynecological cancer studies

Program for Amplification for Children of Texas (PACT)

Programmable pumps, prior authorization

Protective helmets (craniostenosis)

professional organizations

resolution of problems

Provider enrollment

application 1 2

Disclosure of Ownership and Control of Interest Statement

family planning

group practices

Medicaid Audit Information Form

OB-GYN providers

miscellaneous provisions

termination/disenrollment

provider agreement

provider responsibilities

STAR and STAR+PLUS Programs

Medicaid Managed Care Programs

Texas Health Steps (THSteps)

Title V, X, and XX Family Planning

Title XIX Family Planning

Provider Relations, TMHP

Provider responsibilities

billing clients

billing requirements

compliance with

Americans with Disabilities Act of 1990

Civil Rights Act of 1964

Rehabilitation Act of 1973

confidential information

incidental services

medical record documentation requirements

patient acknowledgment statement

procedures for reporting

abuse or neglect

suspected sexual abuse

retention of records

utilization control

Provider-specific visits

Psychiatric hospital (THSteps-CCP)

claim form example

Psychiatric services

chemical dependency treatment

prior authorization

Psychological services

School Health and Related Services (SHARS)

Psychological testing, prior authorization for

benefits and limitations

claim form example 1 2

documentation required

encounter limit

neuropsychological testing

psychological testing

reimbursement 1 2

Public health districts contacts

Pulse oximetry 1 2

Pumps, implantation

Qualified Medicare Beneficiary (QMB) 1 2 3

Radiation services

Radiation therapy

benefits and limitations

claim form example

clinical treatment planning

freestanding radiation therapy facilities/outpatient facilities

medical radiation physics, special services

procedure code limitations

radiation treatment delivery/port films

radiation treatment management

radiation treatment planning

Radiological and physiological laboratory and portable X-ray supplier

claim form example 1 2

Radiological laboratory

Radiology procedures

benefits and limitations

Radiology services 1 2 3

diagnosis requirements

therapeutic radiopharmaceuticals

Radiology, family planning

Radiopharmaceuticals

benefits and limitations

RAST/MAST tests

Record retention

rural health clinic

School Health and Related Services (SHARS)

Reduction mammoplasties

Case Management for Children and Pregnant Women (CPW)

family planning

genetic services

Program for Amplification for Children of Texas (PACT)

Reflux slings, wedges

Registered nurse

additional THSteps educational requirements

Texas Health Steps (THSteps)

Rehabilitation hospital (freestanding) (CCP)

claim form example

ambulatory surgical center

birthing center

case management

for children and pregnant women

for children who are blind and visually impaired

for early childhood intervention

certified nurse-midwife

certified registered nurse anesthetist

certified respiratory care practitioner

chemical dependency treatment facility

chiropractic services

clinical nurse specialist

clinician-directed care coordination services (CCP)

cost reimbursement

drugs/biologicals

durable medical equipment

family planning services

federal financial participation (FFP)

genetic services

hearing aid and audiometric evaluations

high-volume providers

home health services

in-home total parenteral nutrition

independent laboratory

independent practitioners

Indian Health Services

licensed clinical social worker

licensed marriage and family therapist

licensed professional counselors

maternity service clinic

Medicare crossover

nurse practitioner

out-of-state medicaid providers

outpatient facilities

personal care services

physical therapists 1 2

physician assistant 1 2

physician services in outpatient hospital setting

physiological laboratory

portable X-ray supplier

private duty nursing

professional providers

provider-specific visits

radiological and physiological laboratory and portable X-ray supplier

radiological laboratory

reasonable cost/interim rates

renal dialysis facility

RSV prophylaxis

School Health and Related Services

School Health and Related Services (SHARS)

certification of funds

cost reconciliation and cost settlement

random moment time study (RMTS)

certification of funds

tuberculosis clinics

Reimbursement methodology

THSteps-CCP CORFs

THSteps-CCP DME

see Infliximab (Remicade)

Remittance and Status (R&S) Report

adjustments to claims

claims being processed

claims payment summary

delivery options

accounts receivables

backup withholding penalty information

claims in process

paid or denied claims

sub-owner recoupments

void and stop pay

explanation of benefit codes

explanation of columns

explanation of pending status codes

field explanation

financial items

internal control number (ICN)

paid or denied claims

provider inquiries

section explanation

status of claims

see banner pages

Renal dialysis facility

benefits and limitations

claim form example (CAPD/CCPD)

CMS-1500 example

every six months

every three months

hemodialysis, IPD, CCPD, and CAPD training

in-facility dialysis

nonroutine laboratory

routine laboratory

Medicare/Medicaid

reimbursement 1 2

erythropoietin alfa (EPO)

Repair of durable medical equipment (DME), THSteps-CCP

Repairs to client-owned equipment

Replacement of DME

Replacement of equipment/accessories

Reporting abuse and neglect, statutory requirements for

Reservoirs, impantation

Respiratory care

Respiratory equipment

Respiratory syncytial virus (RSV) prophylaxis

see Fluocinolone acetonide (Retisert)

Retroactive eligibility

see Client eligibility

Rho(D) immune globulin

Root canal therapy

see Respiratory syncytial virus

Rural health clinic (RHC)

benefits and limitations

claim form example

freestanding, immunization

claims information

cost report submission

family planning services

record retention

telemedicine services

School Health and Related Services (SHARS)

claim form example

personal care services

record retention

Screening services

hyperlipidemia 1 2

Second opinions

Secretion clearance devices

Sign language interpreting services, physician

physician (THSteps-CCP)

occupational therapists

orthotic and prosthetic suppliers

physical therapists

speech-language pathologists

Silver nitrate applicators

Skin testing, tuberculosis

Sodium ferric gluconate complex in sucrose (Ferrlecit)

Special needs car seats 1 2

Special needs travel restraints

School Health and Related Services (SHARS)

Speech-language pathologists (THSteps-CCP)

claim form example

physician signature

prior authorization

Speech-language therapy 1 2

Spend down, Medically Needy Program

Sports physical examinations

Standing frame/brace

STAR Health Program

client eligibility

adult well check

prescription drugs

spell of illness

client enrollment

automatic re-enrollment

STAR+PLUS Program

client eligibility

dual eligible clients

ineligible clients

mental health claims

spell of illness limitation

State Legalization Impact Assistance Grant (SLIAG)

Statutory requirements

communicable disease reporting 1 2

early childhood intervention (ECI)

Early Childhood Intervention (ECI)

newborn blood screening

newborn screening

parental accompaniment 1 2

reporting abuse and neglect 1 2

teen confidentiality issues

Texas Health Steps (THSteps)

Stem cell transplants

prior authorization

Stereotactic knife radiosurgery

consent form 1 2

attachment to claims

family planning

consent form and instructions

Strontium-89 chloride

Supplemental Security Income (SSI)

anesthesia administered by surgeon

assistant surgeons

prior authorization requirements

bilateral procedures

claim form example

claim form example

global surgery concurrent care

lung volume reduction

office procedures

orthopedic hardware

second opinions

suture of wounds

see Palivizumab

Syphilis testing

Tamper-resistant prescription pads

Tax Equity and Fiscal Responsibility Act (TEFRA)

hospitals reimbursed

physician reimbursement

see Tuberculosis

Teen confidentiality issues, statutory requirements

Teen group counseling, family planning

see Tax Equity and Fiscal Responsibility Act (TEFRA)

hub site provider

remote site provider

Telephone appeals

Telephone numbers

Department of Assistive and Rehabilitative Services (DARS), Blind Services

federal and state

HHSC client communication

Integrated Care Management (ICM)

community health services

inpatient/outpatient prior authorization line

member helpline

provider helpline

prior authorization

Texas Commission for the Blind

HHSC client contact number

Tetanus immunization

Texas Band of Kickapoo Equity Health Program

Texas Board of Nursing (BON)

Texas Health Steps (THSteps)

AAPD Periodicity Guidelines

administrative information

assistance contacts

cervical cancer screening

claim form example (medical check up)

diagnosis and treatment claim form example

claims information

client eligibility

clinical information

Comprehensive Care Program (CCP)

benefits for children

claim filing resources

client eligibility

communicating with

CORF benefits and limitations

CORF claims filing

CORF physician signature

corrective shoes

DME accessories

DME adjustments

DME benefits and limitations

DME mobility aids

DME modifications

DME prior authorization/documentation

DME reimbursement

donor human milk

Early Childhood Intervention (ECI)

ECI claims information

ECI program revisions

electronic blood pressure monitoring device

fittings of orthosis/prostheses

incontinence supplies (DME)

limitations 1 2

medical nutritional products

modifications of orthosis/prostheses

orthotic and prosthetic

pediatric hospital cribs

physician signature

physical therapist

physical therapy services

physician signature

prior authorization

procedure codes

reciprocating gait orthoses

removable shoe insert

special needs car seats

standing frame/brace

thoracic-hip-knee-ankle orthoses (THKAO)

travel restraints

vertical stander

emergency dental referrals

routine dental referrals

dental guidelines

exceptions-to-periodicity checkup

hearing services

intermediate oral evaluation

laboratory services

laboratory supplies

medical checkup

additional required laboratory tests for adolescents

first 6 days of life

newborn eligibility

periodicity schedule, birth-20 years of age

procedure codes

medical home concept

required components of examination

parental accompaniment

periodicity schedules

provider enrollment

Quick Reference Guide 1 2

registered nurse

additional education requirements

rehabilitation hospital (freestanding)

newborn examination

required laboratory screening procedures

STAR Program enrollment

statutory requirements

statutory state requirements

vision services

Texas immunization registry

Texas Kidney Health Care Program

Texas Medicaid & Healthcare Partnership (TMHP)

Texas Medicaid reimbursement

Texas Medical Assistance Program (Medicaid)

Texas Medical Review Program (TMRP)

Texas Vaccines for Children (TVFC) Program 1 2

electronic billing

The Stewart McKinney Act

Therapeutic apheresis

Therapeutic phlebotomy

Third party resources

School Health and Related Services (SHARS)

third party billing agents

vendor implementation

Third Party Resources (TPR)

110-day rule 1 2

accident-related claims

other insurance

claims forward to other insurance carriers

other insurance credits

filing deadlines 1 2

Medicaid Identification (Form H3087)

THSteps requirements

Workers' Compensation

Third-party insurance, family planning

Third-Party Resources (TPR)

Thoracic-hip-knee-ankle orthoses (THKAO)

see Thyrotropin alpha for injection (Thyrogen)

Thyrotropin alpha for injection (Thyrogen)

Title X family planning claims

website, prior authorization requests through

appeal submission

resubmitting rejections

TMHP Provider Relations

Tooth identification (TID) number

Total parenteral nutrition

see also In-home total parenteral supplier

Total parenteral nutrition (TPN)

claim form example

see Third party resources

Transfers of client

Transportation services

School Health and Related Services (SHARS)

Travel restraints

Trigger point injections

see Alatrofloxacin mesylate (Trovan)

Tubal ligation, family planning

claim form example

Tuberculosis Skin Testing

benefits and limitations

see Texas Vaccines for Children

Type of service (TOS) 1 2

claim form (paper) billing

electronic billing

instruction table

Undocumented aliens 1 2

Utilization review

admission review

process, hospital

see Immunizations

Vaccine Adverse Event Reporting System (VAERS)

Vagal nerve stimulators

Vasectomy, family planning

see Vendor Drug Program

Vendor Drug Program 1 2

Ventilator service agreement

Verification of medical checkups

Vertical stander

Vestibuloplasty

benefits and limitations

claim form example

contact lenses 1 2

services not covered

corneal topography

diagnosis codes

prescribing eyewear

Medicare coverage

noncovered services

nonprosthetic eyewear

prosthetic eyewear

provider responsibility

refractive errors

reimbursement 1 2

replacements 1 2

significant diopter change

THSteps services

Vitamin B12 (Cyanocobalamin)

Volume ventilators

Waiver certificate, independent laboratory

Wearable cardiac defibrillator

Wheelchair ramp (portable and threshold)

Women, Infants, and Children (WIC)

Women's Health Program

Women's Health Program (WHP) 1 2

Workers' Compensation 1 2

procedures by podiatrist

Zylonite frames

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