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4.11.6.2 Informational Claims
If providers determine that a TPR may be liable for a Medicaid client's accident-related claim, they can submit an informational claim to the TMHP Tort Department to indicate that a third party is being pursued for payment. This allows providers to secure the 95-day claims filing deadline in the event that the payment is not received from the third party.
TMHP processes informational claims for PCCM, STAR+PLUS, and Medicaid fee-for-service clients. Providers cannot submit an informational claim to TMHP for Medicaid recipients who are receiving benefits from a Medicaid Managed Care Organization (MCO).
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