7.2.6 Claims Filing InformationAll claims for Medicaid Managed Care clients enrolled in a STAR HMO must be submitted to the STAR health plan in which the client is enrolled at the time of service (or date of admission for inpatient hospital claims). The STAR HMO, as a secondary payor, does not determine payment based on the primary payor's authorization of services and/or approval of hospital stays. Exception: TMHP processes some claims for HMO clients. See "Claims Filing Information" for details. |
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Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved. |
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