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7.4.5.1 Hospital Billing
In the Dallas SA, SSI clients are subject to mandatory enrollment in Medicaid Managed Care through the NorthSTAR Program. In some instances, general acute care hospitals treat a NorthSTAR client with a primary behavioral health diagnosis. In that instance, the general acute care hospital needs to seek authorization and reimbursement from ValueOptions using the CMS-1500 form for outpatient services and UB-04 CMS-1450 for inpatient services.
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