Index

Index

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

Abortion services, family planning funding not used for

alcohol and drug use

compliance with Rider 19

confidentiality

DFPS Abuse Hotline

learning problems

reporting 1 2 3

requirements for

staff training on

substance abuse 1 2

Abuse and fraud policy

durable medical equipment (DME) (home health)

resources and refunds

Acronym dictionary

ADA Dental Claim Form Instruction table

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

Central offices

Claims Administrator Contract Management

Limited Program

Medical & 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

chlamydia testing

communicable disease reporting

drug abuse, screening for

eating disorders

gonorrhea testing

hyperlipidemia, screening for

learning problems

mental health assessment

physical examination

screen, THSteps

sexual behavior

screening procedures

sexually transmitted diseases (STDs)

suicide, screening for

tuberculosis testing

Adoption agencies

Advance directives

Advanced practice nurse (APN)

benefits and limitations

After-hours charges

ambulance night calls

Alatrofloxacin mesylate

chemical dependency 1 2 3 4 5

safety practices

Aliens, undocumented, legalized, family planning services for

Allergy services 1 2

allergy injections

benefits and limitations

claim form example 1 2

denials and appeals

emergency services

Medicare disposition

membership fees

prior authorization

nonemergency prior authorization

nonemergency services

prior authorization

emergency out-of-state transport

retroactive eligibility

types, definitions

procedure codes

relation to time of death

multiple client

nursing facility

out-of-locality

state institutions

to or from state institutions

wait time billing

Ambulatory surgical center (ASC)

benefits and limitations

claim form example

claim form example (hospital-based)

dental services

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

administered by surgeon

claim form example

Annual exams, family planning

Anti-Spasmodic drugs

Antihemophilic factor

Apnea monitor 1 2

administrative claim appeals

AIS appeals guide

allowed AIS appeals

advantages of electronic appeal submission

allowed electronic appeals

disallowed electronic appeals

electronic submission

family planning

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

Automated Inquiry System

Bacillus Calmette-Guérin (BCG) vaccine

battery charger

behavioral health services

outpatient, prior authorization for

Behavioral health services

outpatient, prior authorization for

Benefits and limitations

clinician-directed care coordination services (THSteps-CCP only)

occupational therapy

personal care services

private duty nursing

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

laboratory services

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Blepharoplasty procedures

Blind Children's Vocational Discovery and Development Program

benefits and limitations

claim form example

claims information

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Blood counts 1 2

cholesterol 1 2 3

hemoglobin type

Blood transfusions

Body mass index (BMI) 1 2

Bone marrow aspiration

Botulinum toxin type A

Breast and Cervical Cancer Program

client eligibility

Breast imaging studies

Breast reconstruction

Cancer screening

Canes, crutches, walkers

Cardiac blood pool imaging 1 2

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)

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

claims management modifers

epidurals, blood patch

interpreting the R&S report

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Certified respiratory care practitioner (CRCP)

benefits and limitations

claim form example

prior authorization

procedure codes

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Cervical cancer screening

Chemical dependency

behavioral health program

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

STAR, STAR+PLUS, and NorthSTAR Program enrollment

Chest physiotherapy devices

Childhood Lead Poisoning Prevention Program

Children's hospitals

CHIP perinatal program

client eligibility verification

program benefits

Chiropractic services

benefits and limitations

claim form example

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Cholesterol 1 2

Chronic lung disease (CLD)

Circumcisions 1 2

appeal time limits

assistant surgery

banner message R&S example

birthing center

deadline exceptions 1 2

durable medical equipment

electronic billing

electronic submission

setting up access

filing tips for outpatient claims

home health services

incomplete information

interpretations

processing procedures

resubmission of TMHP EDI rejections

THSteps medical modifiers

Claims filing instructions

ambulance transfers

attachments to claims

birthing center

clients without Medicaid numbers

family planning

Family Planning 2017 Claim Form

home health services

Hysterectomy Acknowledgment Statement

multipage claim forms

occurrence codes (HCFA-1450)

provider signature on claims

Claims information

family planning

personal care services

private duty nursing

Client eligibility

Breast and Cervical Cancer Program

CHIP perinatal program

deceased individuals

hospital services

Medicaid identification

restricted Medicaid coverage

selection of provider/pharmacy

Medicaid eligibility verification

Medicaid Identification

Medicare/Medicaid

clients without QMB, MQMB status

contract with outside parties

personal care services

telephone appeals

THSteps medical check up

Clinical Laboratory Improvement Amendments (CLIA)

comprehensive health center

Clinical nurse specialist

benefits and limitations

claim form example

Medicaid Managed Care enrollment

reimbursement 1 2

Clinical records

Clinician-directed care coordination services (THSteps-CCP only)

electronic billing

instruction table 1 2

see clinical nurse specialist

ambulance procedure codes

ambulance providers

diagnosis coding

independent laboratories, pathologists, radiologists

neonatal intensive care codes

place of service (POS) 1 2 3

precoding paper claims

procedure coding

type of bill (TOB)

type of service (TOS)

Commodity supplemental food program

Communicable disease reporting 1 2

Community health centers (CHC)

Comprehensive Care Program (CCP) 1 2

Comprehensive health centers (CHC)

Comprehensive outpatient rehabilitation facility (CORF) 1 2

THSteps-CCP claims filing

claim form example

Computed tomography angiography (CTA)

radiological and physiological laboratory and portable X-ray supplier

Computed tomography imaging (CT)

radiological and physiological laboratory and portable X-ray supplier

Confidential information

procedure codes

Continuity of care

Continuous positive airway pressure (CPAP)

devices, family planning

implantable capsules

Contraction stress test

see Comprehensive Outpatient Rehabilitation Facility (CORF)

Corneal topography

Corrective shoes

Cranial molding devices

Craniostenosis helmets

Crime Victims' Compensation Program

Medically Needy Program

radiological and physiological laboratory and portable X-ray suppliers

Cytogenetics testing for leukemia and lymphoma

Darepoetin alfa

Date of service (DOS)

Denileukin Diftitox

adjunctive general services

benefits and limitations

claims and appeals 1 2

claim form, paper billing

client eligibility

dental assessment guidelines for THSteps medical providers

diagnostic services

doctor of dentistry practicing as a limited physician

electronic claim billing

emergency services

clients over 21

general information

handicapping labiolingual deviation (HLD)

HLD score sheet 1 2

hospitalization

implant services

informed consent

mandatory prior authorization

medical necessity

oral soft tissues

oral/maxillofacial surgery

orthodontic procedure codes

orthodontic services

comprehensive treatment

mandatory prior authorization

special orthodontic appliances

transfer of services

treatment plans

patient education

periodontal services

permanent teeth

preventive services

provider enrollment

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

TMHP contact information

tooth identification (TID) and surface identification (SID)

treatment plans

utilization review

doctor of dentistry

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

contact information

Developmental assessment

Diabetic supplies/equipment

Diagnosis coding

claim form example

Disallowed appeals

family planning

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

and learning problems

psychiatric services

chemotherapeutic

Women's Health Laboratories, Cytopathology Department

durable medical equipment (DME)

accessories (home health)

modifications (home health)

Durable medical equipment (DME)

accessories (THSteps-CCP)

adjustments (THSteps-CCP)

benefits and limitations (THSteps-CCP)

blood pressure devices

claim form example (THSteps-CCP)

incontinence supplies (THSteps-CCP)

mobility aids coding (THSteps-CCP)

modifications (THSteps-CCP)

physician signature (THSteps-CCP)

prior authorization

reimbursement (THSteps-CCP)

rental (THSteps-CCP)

repairs (THSteps-CCP)

repairs (THSteps)

respiratory care equipment (THSteps-CCP)

supplier (THSteps-CCP)

supplier policies (THSteps-CCP)

Durable medical equipment (DME) Certification and Receipt Form

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)

see Texas Health Steps (THSteps)

Early childhood caries

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 3

STAR and STAR+PLUS Program enrollment

Early Chilhood Intervention (ECI)

Eating disorders

Echoencephalography

electronic billing

requests for electronic transmission reports

setting up access

vendor implementation

supported file types

vendor software

family planning

Electrical percussor

Electrocardiogram (EKG)

Electromyography (EMG)

Electronic appeal submission

family planning

Electronic blood pressure monitoring device

Electronic claims submission

Electronic Data Interchange

see EDI and TMHP EDI

Electronic funds transfer

enrollment procedures

refer to type of provider

see also client eligibility

emergency care restrictions 1 2

restricted coverage

Emotional abuse

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

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

THSteps-CCP 1 2

Enteral nutritional products

Enzyme immunoassay

programmable pumps

see also Texas Health Steps (THSteps)

Erythropoietin alfa (EPO) 1 2 3

Esophageal pH probe monitoring

Exceptions to periodicity

External insulin pumps

Extracorporeal membrane oxygenation (ECMO)

Face-to-face services

Family planning

appealing claims

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

incomplete sterilization

injection administration

laboratory procedures

limited Medicaid coverage

Medicaid Managed Care claims

medical counseling

other office visits

outpatient visits

paper appeal submission

parental consent

problem counseling

procedure codes

provider enrollment

provider guidelines

provider requirements

rural health clinic providers

services for undocumented aliens, legalized aliens

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 Services

claim form example

claim form example (APN)

Sterilization Consent Form

Family Planning Services for Hospitals, FQHCs

claim form example

Federal financial participation (FFP) rate

Federally qualified health center (FQHC)

benefits and limitations

claim form example

claim form example (follow-up)

medically necessary services

Medicare-Medicaid crossover claims pricing

newborn eligibility

STAR and STAR+PLUS enrollment

Ferritin and iron studies

Fetal fibronectin

Filing deadlines

family planning

Fluocinolone acetonide

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

Authorization to Release Confidential Information

Birthing Center Report (Form 7484)

Child Abuse Reporting

Child Health History

Claim form examples

Credit Balance Refund Worksheet

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

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

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 4 5 6

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

Prior Authorization Request Form

Intrathecal Baclofen or Morphine Pump Section II

Intrathecal Baclofen or Morphine Pump Sections I and II

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, 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

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

Statement for Initial Wound Therapy System In-Home Use

Sterilization Consent Form

Texas Medicaid Palivizumab (Synagis) Prior Authorization Request Form

Texas Medicaid Vendor Drug Program Palivizumab (Synagis) Prescription Form

Cervical Cancer Cytology Laboratory

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

0-2 Years (Spanish)

10-12 Years (Spanish)

Ages 10-12 Years

Ages 13-20 Years

Ages 13-20 Years (Spanish)

Ages 3-9 Years (Spanish)

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

San Antonio State Chest Hospital Cervical Cancer Cytology Laboratory

Specimen Submission Form G-1B

Specimen Submission Form G-1B, Biochemistry Spanish 1 2

Specimen Submission Form G-1B, Biochemistry, Spanish Instructions

Specimen Submission Form G-2A, Serology and Virology

Specimen Submission Form G-2A, Serology and Virology (Spanish)

Specimen Submission Form G-2A, Serology and Virology, Instructions

Specimen Submission Form G-2A, Serology and Virology, Spanish Instructions

Specimen Submission Form G-2B, Bacteriology and Parasitology

Specimen Submission Form G-2B, Bacteriology and Parasitology (Spanish)

Specimen Submission Form G-2B, Bacteriology and Parasitology, Instructions

Specimen Submission Form G-2B, Bacteriology and Parasitology, Spanish Instructions

Guidelines, Skin Testing

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

Fraud and abuse

suspected cases

Fraud and abuse policy

Gamma knife radiosurgery

Gemcitabine HCI 1 2

Gene mutation analysis, prior authorization for

benefit schedule

claim form example

genetic evaluation and counseling

reimbursement 1 2

Granisetron hydrochloride

Handicapping labiolingual deviation (HLD)

Health Education/Anticipatory Guidance

adolescent development

safety practices

Health maintenance organization (HMO)

Healthcare Common Procedure Coding System (HCPCS)

hearing services

screening 1 2 3

children, 11 years of age and older

children, 4 years of age and older

diagnostic testing 1 2

early hearing detection and intervention

impedance testing

infants, birth-3 years of age

initial test at birth

outpatient screening requirements 1 2

puretone audiometer 1 2

THSteps services

Hearing aid and audiometric evaluations

4 years of age and older

birth thorugh age 3 years of age

claim form example

hearing referrals

hearing screenings

initial test at birth

newborn hearing screening

prior authorization

Heart transplants 1 2 3

Helicobacter pylori 1 2

Hematopoietic agents

Hemoglobin type

screening of pregnant women

central office addresses

complaints and fair hearings

Public Health Region contacts

Public Health Regions map

regional offices

Medicaid eligibility staff

model workplace guidelines

Home health services

augmentative communication device system

authorization of retroactive eligibility

blood glucose monitors

canceling an authorization

change of address/telephone number

claim form example

DME/medical supplies

skilled nursing visit and physical therapy

skilled nursing visits

claims information

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

limitations 1 2

medical supplies

Medicare/Medicaid reimbursement

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