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4.5.1.3 Title X Encounter Filing
In clinics supported by Title X funds, it is important to collect encounter data (such as demographics and services provided) for all family planning clients served, even for full-pay clients, regardless of the funding source to which the claim is billed. This data is used to compile some of the elements of the Family Planning Annual Report. Certain fields on the claim form must be completed for all clients seen at Title X clinics, regardless of the funding source to which the claim is billed. Based on clinic information submitted in the provider's most recent Title X or Title XX request for proposal (RFP), Compass21 rejects all claims from Title X clinics when the claims do not contain all the required information, regardless of the title being billed.
Clients who receive services in a Title X clinic are considered Title X-only clients if their services are not billed to another funding source. In some instances (such as when all Title V or XX funds are expended), services provided to a client normally eligible for another funding source are not billed to that funding source. A client whose income according to family size falls outside the eligibility guidelines for Titles V or XX would also be a Title X-only client. In these cases, a sliding fee scale that has been approved by the DSHS Community Health Services Section must be used to assess client fees for services received.
While it will not result in a payment from DSHS, a Family Planning 2017 Claim Form with Title X encounter information must be submitted to TMHP for all Title X-only clients, so that required encounter data (demographics, and so on) are collected. Encounter forms for Title X clients are filled out the same way as for the other funding sources. Diagnosis information must be entered, and each of the services or tests provided to that client during the visit must be listed on the claim form. Sterilizations provided to Title X clients who are partial pay or no pay must follow the federal guidelines for sterilizations, and a completed Sterilization Consent Form must be faxed to TMHP at 1-512-514-4229.
Providers must forward completed encounter forms to TMHP for processing. Payment for Title X services follows the current voucher submittal process outlined by the DSHS Claims Processing Unit.
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