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4.3.2.7 Hospital Services
An inpatient hospital claim for a limited traditional Medicaid client is considered for reimbursement if the client meets Medicaid eligibility and admission criteria. Hospital admitting personnel are asked to check the name of the designated provider printed under the word "LIMITED" on the client's LIMITED Medicaid Identification and inform the admitting physician of the designated provider's name if the two are different.
Provider claims for nonemergency inpatient services for limited traditional Medicaid clients are considered for payment only when the designated provider identifier appears on the claim form as the billing, performing, or referring physician.
Information about claims reimbursement for limited clients may be received by calling the TMHP Contact Center at 1-800-925-9126 or Assessment Utilization Services at 1-800-436-6184.
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