4.11.6.3 Submission of Informational ClaimsProviders must submit informational claims to TMHP:
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• Refer to: Form 4.2, "Informational Claims Submission Form" in this chapter. Providers must complete either the Insurance Information field (third party resource) or the Attorney Information field on the Informational Claims Submission Form. Providers must send the informational claims and the Informational Claims Submission Form by certified mail to TMHP at:
TMHP/Tort Department TMHP will send providers a letter to confirm that the informational claim was received. The letter will provide the date on which TMHP must receive a request from the provider to convert the informational claim to a claim for payment. If TMHP receives an informational claim that cannot be processed, TMHP will notify the provider of the reason. Providers can inquire about the status of an informational claim by calling the TMHP Third Party Resource Department at 1-800-846-7307. If a provider has not received confirmation that TMHP has received the informational claim within 30 days, the provider should contact the TMHP Third Party Resource Department at 1-800-846-7307 to validate the status of the request. |
On a UB-04 CMS-1450 or CMS-1500 paper claim form. Informational claims cannot be submitted to TMHP electronically or by fax.
