|
New Format for 2010
This year's manual features a new format that makes it easier to access the information providers need. The following outlines the new format:
Volume I: General Information
Volume 1 applies to all health-care providers who are enrolled in Texas Medicaid and provide services to Texas Medicaid clients. The sections in Volume 1 include general information for enrolling in the program, receiving appropriate reimbursement, and claim submissions and appeals for services rendered.
• Contents
•Introduction
•TMHP Telephone and Address Guide
•Section 1. Provider Enrollment and Responsibilities
•Section 2. Texas Medicaid Reimbursement
•Section 3. TMHP Electronic Data Interchange (EDI)
•Section 4. Client Eligibility
•Section 5. Prior Authorization
•Section 6. Claims Filing
•Section 7. Appeals
•Section 8. Managed Care
•Appendix A: State and Federal Offices Communications Guide
•Appendix B: Vendor Drug Program
•Appendix C: HIV/AIDS
•Appendix D: Medical Transportation
•Appendix E: Acronym Dictionary
•Index (for Volume 1 and all handbooks)
Volume 2: Provider Handbooks
Volume 2 includes 11 handbooks. Each handbook covers Medicaid policies, procedures, and claims filing requirements for specific products or services. Volume 2 includes the following handbooks:
•Ambulance Services Handbook
•Behavioral Health, Rehabilitation, and Case Management Services Handbook
•Children's Services Handbook
•Durable Medical Equipment, Mecal Supplies, and Nutritional Products Handbook
•Gynecological and Reproductive Health, Obstetrics, and Family Planning Services Handbook
•Hospital Services Handbook
•Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook
•Nursing and Therapy Services Handbook
•Outpatient Services Handbook
•Radiology, Laboratory, and Physiological Lab Services Handbook
•Vision and Hearing Services Handbook
|
