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43.1.8 Verification of Medical Check Ups
The first source of verification that a THSteps medical check up has occurred is a paid claim or encounter. THSteps encourages providers to file a claim either electronically or on a CMS-1500 claim form as soon as possible after the date of service (DOS), as the paid claim updates client information, including the Medicaid Identification (Form H0387).
The second source of acceptable verification is a physician's written statement that the check up occurred. If the provider chooses to give the client written verification, it must include the client's name, Medicaid ID number, date of the medical check up, and a notation that a complete THSteps medical check up was performed. Verification of medical check ups should not be sent to THSteps but should be maintained by the client to be provided as needed by HHSC eligiblity caseworker.
If neither the first nor the second source of verification is available, a THSteps outreach worker may contact the provider's office for verification.
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