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5.1.4.4 Claims Filing Reminders
After filing a claim to TMHP, providers should review the weekly R&S report. If within 30 days the claim does not appear in the Claims In Process section, or if it does not appear as a paid, denied, or incomplete claim, the provider should resubmit it to TMHP within 95 days from the DOS.
The provider should allow TMHP 45 days to receive a Medicare-paid claim automatically transmitted for payment of deductible, coinsurance, or both.
Electronic billers notify TMHP about missing claims when:
• An accepted claim does not appear on the R&S report within ten workdays of the file submittal.
•A claim or file does not appear on a TMHP Electronic Claims Submission Report within ten days of the file submission.
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