TMPPM 2008 > Provider Information > Client Eligibility > Third Party Resources (TPR)

4.10.2 Adoption Cases

•TMHP/Medicaid, not the adoption agency, should be billed for all medical services that are a benefit of the Texas Medicaid Program.

•If a claim is inadvertently sent to the adoption agency before it is sent to TMHP, TMHP must receive the claim within 95 days of the date of disposition from the adoption agency denial, payment, request for refund or recoupment, to be considered for payment.

•If the adoption agency inadvertently makes a payment for services covered by Medicaid, the provider should refund the payment to the agency.

Refer to: "Claims Filing Deadlines" .

A copy of the non-TPR disposition must be submitted with the claim and received at TMHP within 95 days from the date of the disposition (denial, payment, request for refund, or recoupment of payment by the non-TPR source).