4.10.8.2 Submission of Informational ClaimsA provider must submit an informational claim to HHSC within the 95 days from the date of service. Informational claims will not be accepted after the 95-day filing deadline. All informational claims must be submitted to HHSC by certified mail. PCCM, STAR+PLUS, and traditional Medicaid informational claims should be sent to HHSC for processing. Providers that identify a Medicaid recipient who is receiving benefits provided by a Medicaid Managed Care Organization (MCO) cannot submit an informational claim to HHSC. An informational claim is a paper claim form UB-04 CMS-1450 or CMS-1500 submitted to the HHSC/TPR address with an indication that the provider is seeking payment from a third party for a tort-related liability. Providers cannot submit informational claims electronically. Do not send informational claims to TMHP. When sending an informational claim, the provider must complete an Informational Inquiry Form. Only one Inquiry Form per client is required. Refer to: "Informational Inquiry Form". Providers may inquire on the status of an informational claim by calling HHSC toll-free at 1-800-436-6184 (option 5). This toll-free line only answers questions about informational claims. To ensure that HHSC Third Party Resources Unit receives the original informational claims, providers should send original informational claims by certified mail to the following address:
HHSC/OIG/TPR Note: Faxed informational claims will not be accepted. |
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Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved. |
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