TMPPM 2008 > Texas Medicaid Services > Birthing Center > Benefits and Limitations

10.3.1 Newborn Eligibility Process

To provide a Medicaid number to a child born to a mother eligible for Medicaid, birthing centers must complete the "Birthing Center Report (Newborn Child or Children) Form 7484" on page B-10. Use the following guidelines when completing the Form 7484:

•Enter the newborn's name on the form (if known). The use of "Baby Boy" or "Baby Girl" delays the assignment of a Medicaid number.

•Do not complete the form for stillbirths.

•Submit the form to DSHS within five days of the child's birth. The five-day time frame is not mandatory; however, prompt submission expedites the process of determining the child's eligibility.

•Duplicate Birthing Center Report (Newborn Child or Children) Form 7484 as needed. DSHS and TMHP do not supply this form.

Upon receipt of a completed 7484 form, DSHS verifies the mother's eligibility, and within 10 days sends notification letters to the hospital or birthing center, attending physician (if identified), mother, and caseworker. The notice includes the child's Medicaid number and the effective date of coverage. After the child has been added to the eligibility file, DSHS issues a Medicaid Identification Form (Form H3087) to the client.

Note: Primary Care Case Management (PCCM) clients have up to 105 days to select a primary care provider for their newborns. If clients do not make a selection within the specified time period, a primary care provider will be assigned.

The attending physician's notification letter is sent to the address on file (by license number) at the Texas Medical Board. This address must be kept current to ensure timely notification. Physicians must submit address changes to the following address:

Texas Medical Board
Customer Information, MC-240
PO Box 2018
Austin, TX 78767-2018

Note: When billing for a Medicaid Managed Care client, providers must follow the client's health plan guidelines for newborn billing.