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19.25 Medicaid Dental Claim Filing Resources

Refer to the following sections and/or forms when filing claims:

Resource
Page Number

THSteps-Dental Program:

Automated Inquiry System (AIS)

vii

Client Acknowledgment Statement

1-11

TMHP Electronic Data Interchange (EDI)

3-1

THSteps Dental (ADA) Claim Filing Instructions

5-43

TMHP Electronic Claims Submission

5-13

Criteria for Dental Therapy Under General Anesthesia

19-34

Communication Guide

A-1

THSteps Dental Mandatory Prior Authorization Request Form

B-108

Acronym Dictionary

F-1

Doctor of Dentistry Practicing as a Limited Physician:

Automated Inquiry System (AIS)

vii

TMHP Electronic Data Interchange (EDI)

3-1

CMS-1500 Claim Filing Instructions

5-22

Example of CMS-1500 Claim Form

5-24, D-10

Communication Guide

A-1

Acronym Dictionary

F-1

Texas Medicaid & Healthcare Partnership
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